SAM RICHARD PETERSEN (CRNP) – Registered Nurse, NPI 1386900728
Registered Nurse
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,653 NURSE PRACTITIONER in AL
Provider Addresses for SAM RICHARD PETERSEN (CRNP)
201 SIVLEY RD SW STE 500
HUNTSVILLE, AL 358015177
Phone: (256) 265-3881
Type: Location
1912 AL Highway 157
Cullman, AL 350580609
Phone: (256) 737-2000
Fax: (256) 737-2152
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $48.
Total Amount is formed as General ($48) + Research ($0) + Ownership ($0) = $48.
Last reported payment date: 2024-07-25 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($28).
Total Amount
$48
General + Research + Ownership
Payments
2
Total payment records
General Amount
$48
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $28 |
| PFIZER INC. | $20 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-09-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250905002928 | I | Nurse Practitioner | AL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 35801)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Hospitalist, Internal Medicine | AL | |
| Nurse Practitioner | AL | |
| Nurse Practitioner | AL | |
| Internal Medicine, Hospitalist | AL | |
| - | AL | |
| Internal Medicine | AL | |
| Internal Medicine | AL | |
| Nurse Practitioner | AL | |
| Nurse Practitioner | AL | |
| Hospitalist, Internal Medicine | AL |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.