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NICHOLAS JOHN PETERMAN
NPI 1053069179
Student in an Organized Health Care Education/Training Program in Champaign, IL

Active since March 17, 2022PECOS Enrolled
807 S WRIGHT ST, CHAMPAIGN, IL 61820(513) 728-1343 Get Directions Write a Review

NPPES record last updated: March 17, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Nicholas John Peterman NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICHOLAS JOHN PETERMAN (NPI 1053069179) is an individual student in an organized health care education/training program in Champaign, Illinois and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053069179
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameNICHOLAS JOHN PETERMAN
Location Address807 S WRIGHT STChampaign, IL 61820-6233
Mailing Address807 S Wright StChampaign, IL 61820-6233
Phone(513) 728-1343
Sole ProprietorYes
Enumeration DateMarch 17, 2022
NPPES CertifiedMarch 17, 2022
✔ NPI 1053069179 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
807 S WRIGHT ST, Champaign, IL 61820
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicholas John Peterman is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PRACHI KENI
Student in an Organized Health Care Education/Training Program
807 S WRIGHT ST
CHAMPAIGN, IL 61820
Champaign County (425) 638-2240

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicholas Peterman's NPI number?

The NPI number for Nicholas Peterman is 1053069179. It was assigned to this individual provider in the NPPES registry on March 17, 2022.

Where is Nicholas Peterman located?

Nicholas Peterman practices at 807 S Wright St, Champaign, IL 61820. The listed phone number is (513) 728-1343.

What is Nicholas Peterman's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Nicholas Peterman enrolled in Medicare?

Yes. Nicholas Peterman is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nicholas Peterman was last updated on March 17, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.