Cheryl Jo Peterson, R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

014-226592 Issued in IL

Practice address

2323 Windish Dr
Galesburg, IL 61401-9780

Phone

(309) 344-2323

Fax

(309) 344-4391

NPI assigned

Mar 28, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239667200000",
    "number": "1992824569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W MEMORIAL DR",
            "city": "ABINGDON",
            "state": "IL",
            "postal_code": "614101021",
            "telephone_number": "309-221-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 WINDISH DR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614019780",
            "telephone_number": "309-344-2323",
            "fax_number": "309-344-4391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CHERYL",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2009-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "014-226592",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "IL",
            "license": "014-226592",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "IL",
            "license": "014-226592",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "F.I.N. CORP BRIDGEWAY",
            "identifier": "370984175",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT PROF. REG",
            "identifier": "014-226592",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Michael David Pierson, RPH
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• Registered Nurse in Galesburg, IL
• Providers in Galesburg, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.