Jeffry Lynes Peterson, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Red Bud, IL

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Jeffry Lynes Peterson, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Red Bud, Illinois. He graduated from nursing school in 1997 and has 29 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Memorial Hospital and his current practice location is 10117 Pine Crest Rd, Red Bud, Illinois. You can reach out to his office (for appointments etc.) via phone at (618) 282-2872.

Jeffry Lynes Peterson is licensed to practice in Kentucky (license number 3002489) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1164569729.

Contact Information

Jeffry Lynes Peterson, CRNA
10117 Pine Crest Rd,
Red Bud, IL 62278-4458
(618) 282-2872
Not Available

Map and Direction




Provider's Profile

Full NameJeffry Lynes Peterson
GenderMale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience29 Years
Location10117 Pine Crest Rd, Red Bud, Illinois
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jeffry Lynes Peterson graduated from nursing school in 1997
  NPI Data:
  • NPI Number: 1164569729
  • Provider Enumeration Date: 01/31/2007
  • Last Update Date: 05/29/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 8729164397
  • Enrollment ID: I20120927000800

Medical Identifiers

Medical identifiers for Jeffry Lynes Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1164569729NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered 3002489 (Kentucky)Primary
367500000XNurse Anesthetist, Certified Registered 124294 (Missouri)Secondary
367500000XNurse Anesthetist, Certified Registered 209-000383 (Illinois)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Memorial HospitalChester, ILHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Memorial Hospital529464937229

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jeffry Lynes Peterson allows following entities to bill medicare on his behalf.
Entity NameMemorial Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1851390132
PECOS PAC ID: 5294649372
Enrollment ID: O20031113000382
Entity NameSt Marys Hospital Centralia Illinois
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1770687196
PECOS PAC ID: 6709788920
Enrollment ID: O20040127000118
Entity NameSparta Community Hospital D/b/a Quality Healthcare Clinics
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114984226
PECOS PAC ID: 6709870462
Enrollment ID: O20040414000594
Entity NameSparta Community Hospital
Entity TypePart A Provider - Critical Access Hospital
Entity IdentifiersNPI Number: 1548216476
PECOS PAC ID: 3971408295
Enrollment ID: O20071002000435

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jeffry Lynes Peterson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jeffry Lynes Peterson, CRNA
10117 Pine Crest Rd,
Red Bud, IL 62278-4458

Ph: (270) 898-1922		Jeffry Lynes Peterson, CRNA
10117 Pine Crest Rd,
Red Bud, IL 62278-4458

Ph: (618) 282-2872

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Red Bud, IL

Mr. Earl Gene Draves, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 325 Spring St, Red Bud, IL 62278
Phone: 618-282-3831    Fax: 618-282-1919

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.