Kelley J Peters, NP is a medicare enrolled "Nurse Practitioner - Family" in Antwerp, Ohio. She graduated from nursing school in 2014 and has 11 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Crossroads Urgent Care Pllc and her current practice location is
107 Buffalo Street, Antwerp, Ohio. You can reach out to her office (for appointments etc.) via phone at
(419) 258-5641.
Kelley J Peters is licensed to practice in Tennessee (license number 25358) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1639573694.
Provider's Profile
Full Name | Kelley J Peters |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Experience | 11 Years |
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Location | 107 Buffalo Street, Antwerp, Ohio |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Kelley J Peters graduated from nursing school in 2014
NPI Data:
- NPI Number: 1639573694
- Provider Enumeration Date: 10/20/2014
- Last Update Date: 11/08/2023
Medicare PECOS Information:
- PECOS PAC ID: 8729302740
- Enrollment ID: I20200626000180
Medical Identifiers
Medical identifiers for Kelley J Peters such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1639573694 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | 28145162A (Indiana) | Secondary |
363L00000X | Nurse Practitioner | 71005210A (Indiana) | Secondary |
363L00000X | Nurse Practitioner | COA16762 (Ohio) | Secondary |
363LF0000X | Nurse Practitioner - Family | 25358 (Tennessee) | Primary |
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Crossroads Urgent Care Pllc | 8325117484 | 133 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kelley J Peters allows following entities to bill medicare on her behalf.
Entity Name | Summit Medical Group, Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1659090298 PECOS PAC ID: 2860396330 Enrollment ID: O20031125000793 |
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Entity Name | Crossroads Urgent Care Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1366644361 PECOS PAC ID: 8325117484 Enrollment ID: O20080515000672 |
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Entity Name | Well-key Health Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1114234382 PECOS PAC ID: 1254528763 Enrollment ID: O20101209001106 |
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Entity Name | Dx Mso Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1225381148 PECOS PAC ID: 7719131101 Enrollment ID: O20130213000017 |
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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. Kelley J Peters 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 |
Kelley J Peters, NP Po Box 1047, 107 Buffalo Street, Antwerp, OH 45813-1047 Ph: (419) 258-5641 | Kelley J Peters, NP 107 Buffalo Street, Antwerp, OH 45813-1047 Ph: (419) 258-5641 |
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