JARED PETRICK – Psychiatric/Mental Health Nurse Practitioner, NPI 1932114618
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JARED PETRICK
90 E 200 N
Logan, UT 843210689
Phone: (435) 752-0570
Type: Location
2199 W Ironwood Center Dr
Coeur D Alene, ID 838142639
Phone: (208) 625-4870
Type: Location
West Kootenai Health Way, Coeur d'Alene, Kootenai County, Idaho, 83815, United States
COEUR D ALENE, ID 83814
Phone: (208) 625-4870
Fax: (208) 625-4878
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 60 Open Payments records for all available years, with a total value of $27,822.
Total Amount is formed as General ($27,822) + Research ($0) + Ownership ($0) = $27,822.
Last reported payment date: 2024-06-08 • Largest payer in this snapshot: ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) ($19,815).
Total Amount
$27,822
General + Research + Ownership
Payments
60
Total payment records
General Amount
$27,822
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) | $19,815 |
| ITI, Inc. | $8,007 |
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: 2019-03-29
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 |
|---|---|---|---|---|
| I20190329000247 | I | Nurse Practitioner | ID | 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 84321)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | ID | |
| Orthopedic Surgery | ID | |
| Interventional Cardiology | WA | |
| - | ID | |
| - | WA | |
| Pulmonary Disease, Critical Care (Intensivists), Internal Medicine | ID | |
| - | WA | |
| - | ID | |
| - | OR | |
| Pulmonary Disease, Critical Care (Intensivists) | ID |
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