KOURTNEY PETERSON – Family Nurse Practitioner, NPI 1093165227
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,328 NURSE PRACTITIONER in OK
Provider Addresses for KOURTNEY PETERSON
3000 N GRAND BLVD
OKLAHOMA CITY, OK 731071818
Phone: (405) 632-6688
Type: Mailing
721 W BRITTON RD
OKLAHOMA CITY, OK 731142909
Phone: (405) 632-6688
Type: Location
1025 Straka Ter
Oklahoma City, OK 731392544
Phone: (405) 632-6688
Type: Location
3330, Northwest 56th Street, Oklahoma City, Oklahoma County, Oklahoma, 73112, United States
SUITE 208
OKLAHOMA CITY, OK 731124479
Phone: (405) 604-0688
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $38.
Total Amount is formed as General ($38) + Research ($0) + Ownership ($0) = $38.
Last reported payment date: 2024-10-23 • Largest payer in this snapshot: Hologic Sales and Service, LLC ($22).
Total Amount
$38
General + Research + Ownership
Payments
2
Total payment records
General Amount
$38
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Hologic Sales and Service, LLC | $22 |
| Dexcom, Inc. | $16 |
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: 2018-01-22
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 |
|---|---|---|---|---|
| I20180122000375 | I | Nurse Practitioner | OK | 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 73107)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | OK | |
| - | OK | |
| Family Practice | OK | |
| Certified Nurse Midwife (Cnm) | OK | |
| Family Practice | OK | |
| Family Practice | OK | |
| - | OK | |
| Internal Medicine | OK | |
| Nurse Practitioner | OK | |
| Mental Health Counselor | OK |
Reviews
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