JON KENNON PETERS (NPI# 1720320740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720320740 |
| Entity Type | Individual |
| Full Name | JON KENNON PETERS |
| Credential | FNP |
| Practice Address |
148 Sauls St Ste E Lake City SC 29560-2677 |
| Mailing Address |
Po Box 603898 Charlotte NC 28260-3898 |
| Practice Telephone | 8436999183 |
| Mailing Telephone | 8437926200 |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2019-07-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
18204 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306286539 | Jon C Peters | Social Worker | 707 S Jackson Park Dr, Seymour, IN 47274-2627 | 2013-07-02 |
| 1689776106 | Jon D Peters | Specialist | 12007 Sunrise Valley Dr, Suite 120, Reston, VA 20191-3479 | 2006-09-04 |
| 1053421628 | Jon Peters | Technician, Other | 19 Belmont Ave, Suite 201, Brattleboro, VT 05301-7109 | 2006-08-30 |
| 1083621312 | Jon Peters | Family Medicine | 2647 Ne 33rd Ave, Portland, OR 97212-3647 | 2006-08-01 |
| Street Address |
148 SAULS ST STE E |
| City | LAKE CITY |
| State | SC |
| Zip Code | 29560-2677 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457950222 | Medical University Hospital Authority | Clinic/Center | 148 Sauls St Ste E, Lake City, SC 29560-2677 | 2020-10-22 |
| 1780293290 | Medical University Hospital Authority | Family Medicine | 148 Sauls St Ste E, Lake City, SC 29560-2677 | 2020-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457830366 | Patty Fulmore | In Home Supportive Care | 141 Bulldog Lane, Lake City, SC 29560 | 2018-08-10 |
| 1558875211 | Msk Transportation | Non-emergency Medical Transport (VAN) | 226 Lake Dale Ave, Lake City, SC 29560 | 2017-11-16 |
| 1861867566 | Denita Alison Pleasant | Pharmacist | 301 West Thomas Street, Lake City, SC 29560 | 2015-12-07 |
| 1821474115 | Pro-motion Physical Therapy of Florence, Sc, LLC | Occupational Therapist | 148 B Sauls Street, Lake City, SC 29560 | 2015-08-10 |
| 1023412335 | Motivations-unlimited | Speech-Language Pathologist | 318 A Moore Street, Lake City, SC 29560 | 2014-10-15 |
| 1700297652 | Sharon Lewis | Pharmacist | 900 Us Highway 52, Lake City, SC 29560 | 2014-05-14 |
| 1376954305 | Sergio Montes | Pharmacist | 900 Us Hwy 52, Lake City, SC 29560 | 2014-05-13 |
| 1992122857 | Paula Moses | Pharmacist | 900 U.s Hwy. 52, Lake City, SC 29560 | 2014-03-27 |
| 1063762763 | Dawn Mcelveen Floyd | Pharmacist | 301 W Thomas Street, Lake City, SC 29560 | 2012-09-11 |
| 1548519507 | Robert Bruce Page | Pharmacist | 401 West Thomas St, Lake City, SC 29560 | 2012-09-06 |
| Find all providers in zip 29560 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962954222 | Marisol Isabel Santamarina | Nurse Practitioner | 3239 Nw York Dr, Lake City, FL 32055-8641 | 2016-11-02 |
| 1174063127 | Nicole Polbos | Nurse Practitioner | 1283 Sw State Road 47, Suite 104, Lake City, FL 32025-0489 | 2017-02-24 |
| 1730630880 | Rene Walberto Zambrana | Nurse Practitioner | 751 Se Sycamore Ter, Lake City, FL 32025-6216 | 2016-10-24 |
| 1861429839 | Donna J Caldwell | Nurse Practitioner | 217 Ne Franklin St, Lake City, FL 32055-2981 | 2006-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710588819 | Natalia Milliken | Nurse Practitioner | 4921 Bluffton Pkwy Apt 534, Bluffton, SC 29910-4655 | 2020-11-04 |
| 1447851084 | Paris Gartmon | Nurse Practitioner | 630 Canalside St Unit 1016, Columbia, SC 29201-6030 | 2020-11-02 |
| 1881291722 | Margot Veronique Rabren | Nurse Practitioner | 109 Carter Park Dr # 3a, Seneca, SC 29678-1152 | 2020-10-05 |
| 1134736309 | Holly Leanne Poplin | Nurse Practitioner | 3600 Sea Mountain Hwy, Suite C, Main Street Physicians/sc House Calls Inc, Little River, SC 29566 | 2020-09-30 |
| 1821649344 | Jacqueline G. Stephens | Nurse Practitioner | 406 S Railroad Ave, Lamar, SC 29069-2906 | 2019-09-25 |
| 1780241182 | Adrienne Lendsey Hinton | Nurse Practitioner | 201 Lake Front Dr, Columbia, SC 29212-2422 | 2019-05-22 |
| 1083278279 | Heather Michelle Martin | Nurse Practitioner | 115 Eagles Nest Dr Ste B, Seneca, SC 29678-2762 | 2019-04-24 |
| 1871055210 | Kelli Lane Evans | Nurse Practitioner | 260 W Coleman Blvd Ste A, Mount Pleasant, SC 29464-3666 | 2019-04-04 |
| 1255807087 | Jaclyn Blair Lucchese | Nurse Practitioner | 25 Hospital Center Blvd Ste 105, Hilton Head Island, SC 29926-2735 | 2018-10-19 |
| 1790297497 | Juliann Marie Trumpower | Nurse Practitioner | 9789 Charlotte Hwy Ste 1400, Fort Mill, SC 29707-7186 | 2017-11-02 |
| Find all providers with the same taxonomy | ||||
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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.