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GEORGETTE PETERSON
NPI 1053738781
Licensed Practical Nurse in Paw Paw, MI

Active since March 19, 2014PECOS Enrolled
801 HAZEN ST, PAW PAW, MI 49079(269) 655-3334(269) 657-6523 Get Directions Write a Review

NPPES record last updated: March 19, 2014. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Georgette Peterson NPPES

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

GEORGETTE PETERSON (NPI 1053738781) is an individual licensed practical nurse in Paw Paw, Michigan, licensed in Michigan (4704138858) and active in the NPI registry since March 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053738781
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameGEORGETTE PETERSON
Location Address801 HAZEN STPaw Paw, MI 49079-2008
Mailing Address801 Hazen StPaw Paw, MI 49079-2008 · (269) 655-3334 · Fax (269) 657-6523
Phone(269) 655-3334
Fax(269) 657-6523
Sole ProprietorNo
Enumeration DateMarch 19, 2014
✔ NPI 1053738781 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in MI · 4704138858
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
801 HAZEN ST, Paw Paw, MI 49079
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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)

Georgette Peterson 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 20

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

VAN BUREN COMMUNITY MENTAL HEALTH AUTHORITY
Psychiatry & Neurology (Psychiatry)
801 HAZEN ST, STE C
PAW PAW, MI 49079
Van Buren County (269) 657-5574
VAN BURE COMMUNITY MENTAL HEALTH
Community/Behavioral Health
801 HAZEN ST
PAW PAW, MI 49079
Van Buren County (269) 657-5574
ALEXIS KELLY OTR-L
Occupational Therapist
801 HAZEN ST
PAW PAW, MI 49079
Van Buren County (269) 655-3334
JOHN DUDLEY FUSE
Social Worker
801 HAZEN ST
PAW PAW, MI 49079
Van Buren County (269) 657-5574
KELLIE HOLM LMSW
Social Worker (Clinical)
801 HAZEN ST, SUITE C
PAW PAW, MI 49079
Van Buren County (269) 657-5574
MRS. SARAH LYNN GAMBILL LMSW
Social Worker (Clinical)
801 HAZEN ST
PAW PAW, MI 49079
Van Buren County (269) 657-5574
KIMBERLY DUELL RN
Registered Nurse
801 HAZEN ST
PAW PAW, MI 49079
Van Buren County (269) 657-5574
MARY SCHUMAN
Social Worker
801 HAZEN ST
PAW PAW, MI 49079
Van Buren County (269) 657-5574

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 Georgette Peterson's NPI number?

The NPI number for Georgette Peterson is 1053738781. It was assigned to this individual provider in the NPPES registry on March 19, 2014.

Where is Georgette Peterson located?

Georgette Peterson practices at 801 Hazen St, Paw Paw, MI 49079. The listed phone number is (269) 655-3334.

What is Georgette Peterson's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

Is Georgette Peterson enrolled in Medicare?

Yes. Georgette Peterson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Georgette Peterson was last updated on March 19, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.