KELLY PETERSON (NPI# 1164087730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164087730 |
| Entity Type | Individual |
| Full Name | KELLY PETERSON |
| Credential | APRN, CNP |
| Practice Address |
410 W 10th Ave Columbus OH 43210-1240 |
| Practice Telephone | 6142938000 |
| Mailing Telephone | 6142938000 |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2019-09-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN.382825 | OH | Nursing Service Providers |
| Y | 363LC0200X |
Nurse Practitioner Specialization: Critical Care Medicine |
APRN.CNP.025246 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013450907 | Kelly Rose Peterson | Physical Therapist | 1190 Baker St Ste 105, Costa Mesa, CA 92626-4105 | 2016-11-23 |
| 1326437120 | Kelly Leigh Peterson | Nurse Practitioner | 2200 Childrens Way Monroe Carell Jr, Doctor's Office Tower, 7th Floor, Suite 7100, Nashville, TN 37232-0001 | 2015-01-16 |
| 1336424027 | Kelly Rae Peterson | Nurse Anesthetist, Certified Registered | 9803 Vagabond Ln N, Maple Grove, MN 55311-1364 | 2011-10-13 |
| 1235413758 | Kelly Suzanne Peterson | Naturopath | 638 Fulton St W Suite B, Grand Rapids, MI 49504 | 2011-10-03 |
| 1710016563 | Kelly Peterson | Counselor | 5240 Ne Elam Young Pkwy Ste 100, Hillsboro, OR 97124 | 2007-03-05 |
| 1558399261 | Kelly B Peterson | Dentist | 5100 Grove St, Ste B, Marysville, WA 98270-4492 | 2006-06-29 |
| 1639787872 | Kelly Peterson | Military Health Care Provider | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-07-14 |
| 1255965208 | Kelly A Peterson | Nurse Practitioner | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-02-28 |
| 1639720014 | Kelly Ann Peterson | Counselor | 20288 Highway 15 N Ste 100, Hutchinson, MN 55350-5685 | 2019-09-26 |
| 1366923963 | Kelly Peterson | Counselor | 205 Burlington Rd, Bedford, MA 01730-1406 | 2018-08-22 |
| Street Address |
410 W 10TH AVE |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43210-1240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194720599 | Stephen Thomas Shaw | Internal Medicine | 410 W 10th Ave, Columbus, OH 43210-1240 | 2005-06-14 |
| 1194324376 | Bindu Sahithya Challa | Pathology | 410 W 10th Ave, Columbus, OH 43210-1240 | 2020-10-20 |
| 1912506320 | Qizhi Cao | Nurse Practitioner | 410 W 10th Ave, Columbus, OH 43210-1240 | 2020-10-19 |
| 1033718499 | Audra Goldsberry | Pharmacist | 410 W 10th Ave, Columbus, OH 43210-1240 | 2020-10-17 |
| 1831706720 | Jamie Baldridge | Nurse Practitioner | 410 W 10th Ave, Columbus, OH 43210-1240 | 2020-09-25 |
| 1760098834 | Corey Becker | Nurse Practitioner | 410 W 10th Ave, Columbus, OH 43210-1240 | 2020-09-23 |
| 1942816400 | Thapasya Susan Thomas | Nurse Practitioner | 410 W 10th Ave, Columbus, OH 43210-1240 | 2020-09-21 |
| 1427660299 | Eileen Friery | Pharmacist | 410 W 10th Ave, Columbus, OH 43210-1240 | 2020-08-21 |
| 1124630470 | Gretchen Junker | Pharmacist | 410 W 10th Ave, Columbus, OH 43210-1240 | 2020-08-18 |
| 1205445053 | Allyson Helms | Pharmacist | 410 W 10th Ave, Columbus, OH 43210-1240 | 2020-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861014672 | Nadine El Ayouty | Dentist | 2082 Postle Hall, 305 West 12th Avenue, Columbus, OH 43210 | 2020-05-14 |
| 1982233953 | Zacharia A Grami | Emergency Medicine | 774 Prior Hall, 376 West 10th Avenue, Columbus, OH 43210 | 2020-04-02 |
| 1578191219 | Kaitlyn Greiner | Student in an Organized Health Care Education/Training Program | The Ohio State University Wexner Center, 395 W 12th Avenue, Third Floor, Columbus, OH 43210 | 2020-03-30 |
| 1265069280 | Meryl P Sudhakar | Student in an Organized Health Care Education/Training Program | 774 Prior Hall 376 W 10th Ave, Columbus, OH 43210 | 2020-03-27 |
| 1124653514 | William A Jansak | Nurse Practitioner | The Richard M. Ross Heart Hospital, 4th Floor, 452 West 10th Ave, Columbus, OH 43210 | 2020-03-06 |
| 1114570058 | Suzanne Bartle Haring | Marriage & Family Therapist | 110 Bevis Hall, 1080 Carmack Rd, Columbus, OH 43210 | 2019-07-19 |
| 1487207387 | Mehak Kaul | Dentist | 2196 Postle Hall, 305 West 12th Avenue, Columbus, OH 43210 | 2019-07-19 |
| 1043873920 | Andrew Kendle | Student in an Organized Health Care Education/Training Program | 774 Prior Hall, 374 W. 10th Ave, Columbus, OH 43210 | 2019-04-17 |
| 1093277840 | Cory Pettit | Student in an Organized Health Care Education/Training Program | The Ohio State Universty Wexner Medical Center, 395 W 12th Ave, 3rd Floor, Columbus, OH 43210 | 2019-04-02 |
| 1447711866 | Drew Michael S Donnell | Student in an Organized Health Care Education/Training Program | Osuwmc Dept of Surgery, 395 W. 12th Avenue, Room 662, Columbus, OH 43210 | 2019-03-28 |
| Find all providers in zip 43210 | ||||
| Taxonomy Code | 363LC0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Critical Care Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558810648 | Britney Ann Iannantuono | Nurse Practitioner | 3535 Olentangy River Rd Ste 6300, Columbus, OH 43214-3908 | 2016-09-29 |
| 1932577269 | Rebecca Gallagher | Nurse Practitioner | 6001 E Broad St, Columbus, OH 43213-1502 | 2015-09-03 |
| 1215924956 | Sandra Jacobs | Nurse Practitioner | 555 S 18th St, Columbus, OH 43205-2696 | 2005-09-27 |
| 1245235696 | Jennifer L James | Nurse Practitioner | 3705 Olentangy River Rd, Ste 100, Columbus, OH 43214-3467 | 2005-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518593730 | Scott Michael Hartman | Nurse Practitioner | 630 East River Streer, Elyria, OH 44035 | 2020-03-19 |
| 1740831080 | Michelle Renee Gayheart | Nurse Practitioner | 860 E Broad St Ste 1, Elyria, OH 44035-6542 | 2019-09-27 |
| 1134744378 | Stacey Michelle Callison | Nurse Practitioner | 9000 N Main St, Englewood, OH 45415-1180 | 2020-06-13 |
| 1225651029 | Stephanie Dawson | Nurse Practitioner | 2142 N Cove Blvd, Toledo, OH 43606-3895 | 2020-05-27 |
| 1821617903 | Kevin Barth | Nurse Practitioner | 2142 N Cove Blvd, Toledo, OH 43606-3895 | 2020-04-09 |
| 1811521248 | Amanda D Lott | Nurse Practitioner | 1003 Bellefontaine Ave Ste 150, Lima, OH 45804-1871 | 2020-02-25 |
| 1689228538 | Deja Lea Hillman | Nurse Practitioner | 1 Medical Center Dr, Middletown, OH 45005-2584 | 2019-07-30 |
| 1699328294 | Patricia Albano-seitz | Nurse Practitioner | 730 W Market St, Lima, OH 45801-4602 | 2019-07-23 |
| 1447803069 | Christian Daniel Brienik | Nurse Practitioner | 2500 Metrohealth Dr, Cleveland, OH 44109-1900 | 2019-07-23 |
| 1629637780 | Tyler Jacob Jones | Nurse Practitioner | 9500 Euclid Ave, Cleveland, OH 44195-0001 | 2019-06-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.