KELLEY J PETERS (NP) – Family Nurse Practitioner, NPI 1639573694
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
15,061 NURSE PRACTITIONER in OH
Provider Addresses for KELLEY J PETERS (NP)
PO BOX 1047
107 BUFFALO STREET
ANTWERP, OH 458131047
Phone: (419) 258-5641
Fax: (419) 258-2711
Type: Mailing
107 BUFFALO STREET
ANTWERP, OH 458131047
Phone: (419) 258-5641
Fax: (419) 258-2711
Type: Location
8635 Middlebrook Pike
Knoxville, TN 379231612
Phone: (865) 824-0079
Fax: (833) 908-2101
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: 2020-06-26
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20200626000180 | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 25 | 24 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 19 | 19 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 16 | 16 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 14 | 14 | $0 |
| 81003 | Automated urinalysis test | 11 | 11 | $0 |
Insurance plans in this area (ZIP 45813)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TN | |
| - | TN | |
| Nurse Practitioner | TN | |
| - | TN | |
| Nurse Practitioner | TN | |
| Nurse Practitioner | TN | |
| Nurse Practitioner | TN | |
| Physician Assistant | NC | |
| - | TN | |
| Physician Assistant | IL |
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