MRS. CASEY CRUMP PETERSON (NP-C) – Family Nurse Practitioner, NPI 1609239938
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,744 NURSE PRACTITIONER in GA
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Provider Addresses for MRS. CASEY CRUMP PETERSON (NP-C)
817, Griffin Avenue, Eastman, Dodge County, Georgia, 31023, United States
EASTMAN, GA 310236718
Phone: (478) 374-1801
Fax: (478) 448-4586
Type: Mailing
PROSPERO HEALTH PARTNERS PC
PROMENADE II 1230 PEACHTREE ST. NE 19TH FLOOR
ATLANTA, GA 303093574
Phone: (866) 949-0108
Type: Mailing
40 S MAIN ST STE 1300
MEMPHIS, TN 381035513
Phone: (866) 949-0108
Fax: (866) 620-4792
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2026-02-18
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20160906001207 | I | Nurse Practitioner | GA | TBD |
| I20260218004102 | I | Nurse Practitioner | TN | 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 31023)
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