ANETHA DEBORAH PETERSON FNP
NPI 1093189904
Nurse Practitioner - Family in Atlanta, GA
About Anetha Deborah Peterson Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANETHA DEBORAH PETERSON FNP (NPI 1093189904) is an individual family provider in Atlanta, Georgia, licensed in Georgia (RN164175) and active in the NPI registry since November 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2014).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Anetha Deborah Peterson Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Anetha Peterson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Macon, GA 31210
- Reassigned Medicare billing, Georgia enrollment
- 635 clinicians in this Medicare group
Fairbanks, AK 99701
- Reassigned Medicare billing, Texas enrollment
- 207 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30309 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Reported Quality Measures
Referred Medical Equipment & Supplies CMS DME claims
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
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 Anetha Peterson's NPI number?
The NPI number for Anetha Peterson is 1093189904. It was assigned to this individual provider in the NPPES registry on November 17, 2015.
Where is Anetha Peterson located?
Anetha Peterson practices at 2171 Peachtree Road NE Apt 306, Atlanta, GA 30309. The listed phone number is (678) 464-9424.
What is Anetha Peterson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Anetha Peterson enrolled in Medicare?
Yes. Anetha Peterson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Anetha Peterson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Anetha Peterson reassigns Medicare benefits to 2 organizations: Cogent Healthcare Of Georgia PC (Macon, GA) and Tanana Chiefs Conference (Fairbanks, AK). Each 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 Anetha Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Anetha Peterson was last updated on November 17, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Anetha Deborah Peterson, FNP · NPI 1093189904
Family physician in Atlanta, Georgia. Individual provider, active in the CMS NPPES registry since November 17, 2015.
## Identity
- **NPI:** 1093189904 (Entity type: Individual)
- **Enumerated:** November 17, 2015
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** RN164175 (Georgia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2171 PEACHTREE ROAD NE, APT 306, Atlanta, GA 30309
- **Phone:** (678) 464-9424
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Cogent Healthcare Of Georgia PC (NPI 1609827823, Macon, GA); Tanana Chiefs Conference (NPI 1821201278, Fairbanks, AK) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2014
## Record status
- **NPPES last updated:** November 17, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1093189904) · Data from the CMS NPPES public registry.