STORY PETERSON (NPI# 1578001038) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578001038 |
| Entity Type | Individual |
| Full Name | STORY PETERSON |
| Credential | AGNP-C |
| Practice Address |
5514 Corporate Dr Ste 120 Saint Joseph MO 64507-7754 |
| Practice Telephone | 8162717169 |
| Practice Fax Number | 8162718810 |
| Mailing Telephone | 8162717169 |
| Mailing Fax Number | 8162718810 |
| Enumeration Date | 2017-02-05 |
| Last Update Date | 2018-12-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
AG01170222 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
2017013256 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5514 CORPORATE DR STE 120 |
| City | SAINT JOSEPH |
| State | MO |
| Zip Code | 64507-7754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891728408 | Diane E Waddell | Nurse Practitioner | 5514 Corporate Dr Ste 120, Saint Joseph, MO 64507-7754 | 2006-07-08 |
| 1710511258 | Marti Jean Burri | Nurse Practitioner | 5514 Corporate Dr Ste 120, Saint Joseph, MO 64507-7754 | 2020-02-24 |
| 1750870846 | Crystal Lyn Ashburn | Nurse Practitioner | 5514 Corporate Dr Ste 120, Saint Joseph, MO 64507-7754 | 2018-05-04 |
| 1730321621 | Katherine Anne Lane | Nurse Practitioner | 5514 Corporate Dr Ste 120, Saint Joseph, MO 64507-7754 | 2009-03-24 |
| 1740358282 | Thomas R. Holda | Internal Medicine | 5514 Corporate Dr Ste 120, Saint Joseph, MO 64507-7754 | 2006-12-01 |
| 1326066408 | James A Direnna | Family Medicine | 5514 Corporate Dr Ste 120, Saint Joseph, MO 64507-7754 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346644044 | Janaha Anderson | Dental Hygienist | 4073 Se Cunningham Rd, St. Joseph, MO 64507 | 2014-10-09 |
| 1518229772 | Andrew L Walker | Radiology | 902 N Riverside Rd Ste 201, Saint Joseph, MO 64507 | 2012-06-13 |
| 1619105731 | Pamela M. Lotz | Clinical Nurse Specialist | 902 No. Riverside Rd, Suite 200, St. Joseph, MO 64507 | 2009-06-26 |
| 1356300735 | St Joseph Oncology Inc | Internal Medicine | 902 No Riverside Rd, Suite 200, St Joseph, MO 64507 | 2006-03-22 |
| 1962478560 | Douglas Chyatte | Neurological Surgery | 802 N Riverside Rd Ste 120, Saint Joseph, MO 64507 | 2006-02-24 |
| 1073089546 | Chaz Caleb Johnson | Physical Therapist | 5506 Corporate Dr Ste 1800, Saint Joseph, MO 64507 | 2018-10-22 |
| 1295228344 | Julie Odonnell Phd LLC | Clinic/Center | 708 S Woodbine Rd Ste A, Saint Joseph, MO 64507 | 2018-06-13 |
| 1912369695 | Luke Nathan Prest | Pediatrics | 902 N Riverside Rd Ste 100, Saint Joseph, MO 64507 | 2016-03-22 |
| 1396007894 | Brian Wright Roe | Internal Medicine | 5514 Corporate Dr Ste 150, Saint Joseph, MO 64507 | 2012-06-11 |
| 1861873952 | Edison Derr II | Specialist/Technologist | 2214 Maple St, Saint Joseph, MO 64507-1413 | 2015-06-15 |
| Find all providers in zip 64507 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215452289 | Miranda Marie Floyd | Nurse Practitioner | 802 N Riverside Rd Ste G50, Saint Joseph, MO 64507-2510 | 2017-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023632932 | Rebecca Theresa Medlock | Nurse Practitioner | 736 Marco Valley Ct, Fenton, MO 63026-5318 | 2020-06-05 |
| 1083233274 | Gina Hart | Nurse Practitioner | 12101 Woodcrest Executive Dr Ste 102, Saint Louis, MO 63141-5047 | 2020-04-08 |
| 1215569512 | Nicole M Wikoff | Nurse Practitioner | 12415 Hickory Grove Ln, Saint Louis, MO 63146-3907 | 2020-02-05 |
| 1124658257 | Amadu Barrie | Nurse Practitioner | 134 Midland Avenue, Maryland Heights, MO 63043 | 2020-01-16 |
| 1922569995 | Sarah Regan | Nurse Practitioner | 1031 Bellevue Ave Ste 100, Saint Louis, MO 63117-1855 | 2019-03-30 |
| 1437615044 | Ashley M Berneking | Nurse Practitioner | 4122 Keaton Crossing Blvd Ste 102, O Fallon, MO 63368-8219 | 2019-02-19 |
| 1174094072 | Michelle Kay Bank | Nurse Practitioner | 12409 Roth Hill Dr, Maryland Heights, MO 63043-2941 | 2018-12-17 |
| 1861968612 | Nasir Gebi | Nurse Practitioner | 603 E Minor Dr Apt 202, Kansas City, MO 64131-3688 | 2018-10-19 |
| 1457839573 | Robert Claude Kamtio Kamgoum | Nurse Practitioner | 406 W 34th St Ste 428, Kansas City, MO 64111-3113 | 2018-07-31 |
| 1639613813 | University of Missouri | Nurse Practitioner | 1100 Virginina Ave, Columbia, MO 65212-0001 | 2016-12-07 |
| Find all providers with the same taxonomy | ||||
| City | SAINT JOSEPH |
| Zip Code | 64507 |
Please comment or provide details below to improve the information on STORY PETERSON.
| 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.