Krystal Peterson, is a medicare enrolled "Nurse Practitioner - Family" in Effingham, South Carolina. Her current practice location is
1217 Turtle Dove Dr, Effingham, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(843) 472-8322.
Krystal Peterson is licensed to practice in South Carolina (license number 28462) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1902662174.
Provider's Profile
| Full Name | Krystal Peterson |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 1217 Turtle Dove Dr, Effingham, South Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1902662174
- Provider Enumeration Date: 02/26/2024
- Last Update Date: 04/23/2024
Medicare PECOS Information:
- PECOS PAC ID: 7416478110
- Enrollment ID: I20250311001379
Medical Identifiers
Medical identifiers for Krystal Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1902662174 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 28462 (South Carolina) | Primary |
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. Krystal Peterson allows following entities to bill medicare on her behalf.
| Entity Name | Longevity Clinical Ltc Associates Of South Carolina Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1184317984
PECOS PAC ID: 6800241001
Enrollment ID: O20231009000147 |
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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. Krystal 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 Address | Practice Location Address |
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Krystal Peterson,
1217 Turtle Dove Dr,
Effingham, SC 29541-4721
Ph: (843) 472-8322 | Krystal Peterson,
1217 Turtle Dove Dr,
Effingham, SC 29541-4721
Ph: (843) 472-8322 |
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