JERREKA PETERSON AGACNP
NPI 1104415827
Nurse Practitioner - Acute Care in Colonial Heights, VA

Q: What is Jerreka Peterson's NPI number?

The NPI number for Jerreka Peterson is 1104415827. It was assigned to this individual provider in the NPPES registry on January 17, 2021.

Q: What is Jerreka Peterson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Jerreka Peterson was last updated on September 23, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since January 17, 2021PECOS Enrolled

524 SOUTHPARK BLVD, COLONIAL HEIGHTS, VA 23834(804) 504-7980(804) 554-5387 Get Directions Write a Review

NPPES record last updated: September 23, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 5, 2023, Mar 25, 2021, Jan 17, 2021 (3 updates tracked since 2021).

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About Jerreka Peterson Agacnp NPPES

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

JERREKA PETERSON AGACNP (NPI 1104415827) is an individual acute care provider in Colonial Heights, Virginia, licensed in Virginia (0024180529) and active in the NPI registry since January 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104415827

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameJERREKA PETERSONCredential: AGACNP

Location Address524 SOUTHPARK BLVDColonial Heights, VA 23834-3609

Mailing Address524 Southpark BlvdColonial Heights, VA 23834-3609 · (804) 504-7980 · Fax (804) 554-5387

Phone(804) 504-7980

Fax(804) 554-5387

Sole ProprietorNo

Enumeration DateJanuary 17, 2021

Last NPPES UpdateSeptember 23, 20253 updates tracked since enumeration

NPPES CertifiedSeptember 23, 2025

✔ NPI 1104415827 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in VA · 0024180529

524 SOUTHPARK BLVD, Colonial Heights, VA 23834

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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)

Jerreka Peterson Agacnp 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23834 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$99.13 typical visit price

range $18.07 – $138.91

Typical copayment $24.78 (range $4.51 – $34.72)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 15

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

LAURA WONG

Acupuncturist

524 SOUTHPARK BLVD, JENCARE NEIGHBORHOOD MEDICAL SOUTH PARK, LLC
COLONIAL HEIGHTS, VA 23834

Colonial Heights City (804) 504-7980

DR. REMAN DHALIWAL DPM

Podiatrist