Kelley J Peters, NP - Medicare Nurse Practitioner in Antwerp, OH

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Kelley J Peters, NP is a medicare enrolled "Nurse Practitioner - Family" in Antwerp, Ohio. She graduated from nursing school in 2014 and has 10 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Summit Medical Group, Pllc, Crossroads Urgent Care Pllc and her current practice location is 107 Buffalo Street, Antwerp, Ohio. You can reach out to her office (for appointments etc.) via phone at (419) 258-5641.

Kelley J Peters is licensed to practice in Tennessee (license number 25358) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1639573694.

Contact Information

Kelley J Peters, NP
107 Buffalo Street,
Antwerp, OH 45813-1047
(419) 258-5641
(419) 258-2711

Map and Direction




Provider's Profile

Full NameKelley J Peters
GenderFemale
SpecialityNurse Practitioner
Experience10 Years
Location107 Buffalo Street, Antwerp, Ohio
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Kelley J Peters graduated from nursing school in 2014
  NPI Data:
  • NPI Number: 1639573694
  • Provider Enumeration Date: 10/20/2014
  • Last Update Date: 11/08/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 8729302740
  • Enrollment ID: I20200626000180

Medical Identifiers

Medical identifiers for Kelley J Peters such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1639573694NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse 28145162A (Indiana)Secondary
363L00000XNurse Practitioner 71005210A (Indiana)Secondary
363L00000XNurse Practitioner COA16762 (Ohio)Secondary
363LF0000XNurse Practitioner - Family 25358 (Tennessee)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Summit Medical Group, Pllc2860396330485
Crossroads Urgent Care Pllc8325117484139

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. Kelley J Peters allows following entities to bill medicare on her behalf.
Entity NameSummit Medical Group, Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1659090298
PECOS PAC ID: 2860396330
Enrollment ID: O20031125000793
Entity NameCrossroads Urgent Care Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1366644361
PECOS PAC ID: 8325117484
Enrollment ID: O20080515000672
Entity NameWell-key Health Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114234382
PECOS PAC ID: 1254528763
Enrollment ID: O20101209001106
Entity NameDx Mso Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1225381148
PECOS PAC ID: 7719131101
Enrollment ID: O20130213000017

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. Kelley J Peters 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
Kelley J Peters, NP
Po Box 1047, 107 Buffalo Street,
Antwerp, OH 45813-1047

Ph: (419) 258-5641		Kelley J Peters, NP
107 Buffalo Street,
Antwerp, OH 45813-1047

Ph: (419) 258-5641

Reviews and Comments


Nurse Practitioner Nurses in Antwerp, OH

Mrs. Kori L. Strubing, NP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 422 W River St, Antwerp, OH 45813
Phone: 419-258-5195    Fax: 419-258-2620

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.