KERRY PETERSON FNP
NPI 1073939427
Nurse Practitioner - Family in Montesano, WA
About Kerry Peterson Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KERRY PETERSON FNP (NPI 1073939427) is a healthcare organization registered as a family in Montesano, Washington and active in the NPI registry since March 2014. The organization lists Kerry Peterson, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kerry Peterson Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Kerry Peterson Fnp, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Kgp LLC's NPI number?
The NPI number for Kgp LLC is 1073939427. It was assigned to this organization in the NPPES registry on March 10, 2014. The provider is doing business as Kerry Peterson Fnp.
Where is Kgp LLC located?
Kgp LLC is located at 319 E Pioneer Ave, Montesano, WA 98563. The listed phone number is (360) 249-1980.
What is Kgp LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kgp LLC enrolled in Medicare?
Yes. Kgp LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Kgp LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Kgp LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Kgp LLC accept?
Health plans from Premera Blue Cross Blue Shield of Alaska list Kgp LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kgp LLC was last updated on March 10, 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.
# Kerry Peterson Fnp · NPI 1073939427
Family organization in Montesano, Washington. Organization record, active in the CMS NPPES registry since March 10, 2014.
## Identity
- **NPI:** 1073939427 (Entity type: Organization)
- **Enumerated:** March 10, 2014
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Legal business name:** Kgp Llc
- **Organization subpart:** No
- **Authorized official:** Kerry Peterson, OWNER
## Practice location
- **Address:** 319 E PIONEER AVE, Montesano, WA 98563-4601
- **Phone:** (360) 249-1980
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 10, 2014
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Source: [NPI Profile](https://npiprofile.com/npi/1073939427) · Data from the CMS NPPES public registry.