Jeffry Lynes Peterson, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Red Bud, Illinois. His current practice location is
10117 Pine Crest Rd, Red Bud, Illinois. You can reach out to his office (for appointments etc.) via phone at
(618) 282-2872.
Jeffry Lynes Peterson is licensed to practice in Kentucky (license number 3002489) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1164569729.
Provider's Profile
Full Name | Jeffry Lynes Peterson |
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Gender | Male |
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Speciality | |
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Experience | Years |
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Location | 10117 Pine Crest Rd, Red Bud, Illinois |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Jeffry Lynes Peterson attended and graduated from in
NPI Data:
- NPI Number: 1164569729
- Provider Enumeration Date: 01/31/2007
- Last Update Date: 02/04/2020
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Jeffry Lynes Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1164569729 | NPI | - | NPPES |
7424890700 | Medicaid | KY | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
367500000X | Nurse Anesthetist, Certified Registered | 124294 (Missouri) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 209-000383 (Illinois) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 3002489 (Kentucky) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jeffry Lynes Peterson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jeffry Lynes Peterson, CRNA 10117 Pine Crest Rd, Red Bud, IL 62278-4458 Ph: (270) 898-1922 | Jeffry Lynes Peterson, CRNA 10117 Pine Crest Rd, Red Bud, IL 62278-4458 Ph: (618) 282-2872 |
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