Jeannie Marie Peterson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

55028 Issued in KS

Practice address

1102 W 32ND St
Joplin, MO 64804-3503

Phone

(417) 347-1111

NPI assigned

Jan 25, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in KS, MO2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Pittsburg LLCGroup PAC ID 7618418088, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Pittsburg, Inc Hospital, Pittsburg, KS, CCN 170006
• Girard Medical Center Hospital, Girard, KS, CCN 171376

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicmobile.corp.saint-lukes.org/FHIRPROXY/api/FHIR/R4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mercy Clinic Pittsburg LLC

  • Internal Medicine Physician
  • Pittsburg, KS
  • NPI 1912751884

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Cox Barton County Hospital

  • Emergency Medicine Physician
  • Lamar, MO
  • NPI 1174166177
  Medicare reassignment NPD
• Coffeyville Regional Medical Center Inc

  • Anesthesiology Physician
  • Coffeyville, KS
  • NPI 1265550891
  Medicare reassignment NPD
• Freeman Surgical Center of Pittsburg, LLC

  • Ambulatory Surgical Clinic/Center
  • Pittsburg, KS
  • NPI 1881089076
  Medicare reassignment NPD
• Saint Luke'S Hospital of Allen County, Inc

  • Critical Access Hospital
  • Iola, KS
  • NPI 1639185457
  Medicare reassignment NPD
• Saint Lukes Hospital of Garnett Inc

  • Critical Access Hospital
  • Garnett, KS
  • NPI 1316911878
  Medicare reassignment NPD
• Saint Lukes Hospital of Garnett Inc

  • General Practice Physician
  • Garnett, KS
  • NPI 1619901725
  Medicare reassignment NPD
• Coffeyville Regional Medical Center, Inc.

  • Critical Access Hospital
  • Coffeyville, KS
  • NPI 1285600379
  NPD
• Saint Luke'S Hospital of Allen County, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Iola, KS
  • NPI 1912914888
  NPD
• Saint Lukes Hospital of Garnett Inc

  • Rural Health Clinic/Center
  • Colony, KS
  • NPI 1487075586
  NPD
• Ambulatory Anesthesia Services of Missouri LLC

  • Anesthesiology Physician
  • Joplin, MO
  • NPI 1780831107

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Freeman Neosho Hospital

  • Anesthesiology Physician
  • Neosho, MO
  • NPI 1164451746

  Nurse Anesthetist, Certified Registered

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hospital District No 1 Crawford County

  • Critical Access Hospital
  • Girard, KS
  • NPI 1578505095
  Care Compare affiliation
• Mercy Hospital Pittsburg Inc

  • General Acute Care Hospital
  • Pittsburg, KS
  • NPI 1639921430
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1992775506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 N HOSPITAL DR",
            "city": "GIRARD",
            "state": "KS",
            "postal_code": "667432000",
            "telephone_number": "417-347-1078",
            "fax_number": "417-347-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 W 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043503",
            "telephone_number": "417-347-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29 NW 1st Ln",
            "address_purpose": "LOCATION",
            "city": "LaMar",
            "state": "MO",
            "postal_code": "647598105",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JEANNIE",
        "middle_name": "MARIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "55028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100787980A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "915240105",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100389550D",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "430061375",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Makenzie Petermann, M.S. CCC-SLP
• Kari Lynn Petersen, LMSW
• Corey Nathaniel Peterson, DPT
• Heather N Peterson, LCSW
• Heidi Jane Peterson, CRNA
• Shawn Larae Peterson, PTA
• Henry D. Petry, DO
• Paul David Petry, D.O.
• Kendyl Petty
• Sean C Pfeffer, MD

• Certified Registered Nurse Anesthetist in Joplin, MO
• Providers in Joplin, MO by specialty
• Certified Registered Nurse Anesthetist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.