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MR. KELLY ANDREW PETERSON
NPI 1093523144
Adult Companion in Grand Island, NE

Active since December 20, 2024
709 E 11TH ST, GRAND ISLAND, NE 68801(308) 385-5775 Get Directions Write a Review

NPPES record last updated: December 26, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 26, 2024, Dec 20, 2024 (2 updates tracked since 2024).

About Mr. Kelly Andrew Peterson NPPES

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

MR. KELLY ANDREW PETERSON (NPI 1093523144) is an individual adult companion provider in Grand Island, Nebraska and active in the NPI registry since December 2024. He maintains a secondary practice location in Grand Island.

NPPES Registry Identity

NPI1093523144
Entity TypeIndividualMale
Primary Taxonomy372600000X
Provider Legal NameMR. KELLY ANDREW PETERSON
Location Address709 E 11TH STGrand Island, NE 68801-2603
Mailing Address2536 Carleton AveGrand Island, NE 68803-1221 · (308) 385-5775 · Fax (308) 385-5780
Phone(308) 385-5775
Sole ProprietorNo
Enumeration DateDecember 20, 2024
Last NPPES UpdateDecember 26, 20242 updates tracked since enumeration
NPPES CertifiedDecember 26, 2024
✔ NPI 1093523144 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAdult CompanionNursing Service Related Providers
Taxonomy Code372600000X
Definition
An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care.
709 E 11TH ST, Grand Island, NE 68801
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Secondary Practice Location 1

Location 12536 Carleton AveGrand Island, NE 68803-1221 · Phone (308) 385-5775 · Fax (308) 385-5780

Other Providers at the Same Location NPPES 4

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

MS. LINETTE DERR
Adult Companion
709 E 11TH ST
GRAND ISLAND, NE 68801
Hall County (308) 385-5775
MISS JENNIE CLARICE KNAPP
Adult Companion
709 E 11TH ST
GRAND ISLAND, NE 68801
Hall County (308) 385-5775
MR. MAKUEI R ACHUOTH
Adult Companion
709 E 11TH ST
GRAND ISLAND, NE 68801
Hall County (308) 385-5775
MISS SHEILA MAE JOHNSON
Adult Companion
709 E 11TH ST
GRAND ISLAND, NE 68801
Hall County (308) 385-5775

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 Kelly Peterson's NPI number?

The NPI number for Kelly Peterson is 1093523144. It was assigned to this individual provider in the NPPES registry on December 20, 2024.

Where is Kelly Peterson located?

Kelly Peterson practices at 709 E 11th St, Grand Island, NE 68801. The listed phone number is (308) 385-5775.

What is Kelly Peterson's specialty?

The primary specialty registered for this NPI is Adult Companion with taxonomy code 372600000X.

When was this NPI record last updated?

The NPPES record for Kelly Peterson was last updated on December 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.