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JIMMIE PETERSON
NPI 1417483405
Peer Specialist in Oklahoma City, OK

Active since May 11, 2017
4913 W RENO AVE, OKLAHOMA CITY, OK 73127(405) 948-4900(405) 948-4933 Get Directions Write a Review

NPPES record last updated: December 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 22, 2020, May 11, 2017 (2 updates tracked since 2017).

About Jimmie Peterson NPPES

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

JIMMIE PETERSON (NPI 1417483405) is an individual peer specialist in Oklahoma City, Oklahoma and active in the NPI registry since May 2017. He maintains a secondary practice location in Oklahoma City.

NPPES Registry Identity

NPI1417483405
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameJIMMIE PETERSON
Location Address4913 W RENO AVEOklahoma City, OK 73127-6339
Mailing Address4913 W Reno AveOklahoma City, OK 73127-6339 · (405) 948-4900
Phone(405) 948-4900
Fax(405) 948-4933
Sole ProprietorYes
Enumeration DateMay 11, 2017
Last NPPES UpdateDecember 22, 20202 updates tracked since enumeration
NPPES CertifiedDecember 21, 2020
✔ NPI 1417483405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
4913 W RENO AVE, Oklahoma City, OK 73127
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Secondary Practice Location 1

Location 112821 Stratford Dr Apt 236Oklahoma City, OK 73120-8438 · Phone (405) 361-9807

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.

CHASE TE IDLEMAN RDH
Dental Hygienist
4913 W RENO AVE
OKLAHOMA CITY, OK 73127
Oklahoma County (405) 948-4900
MRS. KATERI SUZANNA BOHANAN LCSW
Social Worker (Clinical)
4913 W RENO AVE
OKLAHOMA CITY, OK 73127
Oklahoma County (405) 948-4900
NICOLE LEE
Physician Assistant
4913 W RENO AVE
OKLAHOMA CITY, OK 73127
Oklahoma County (405) 948-4900
MEGHANN LAUREL TILLISON LMFT
Marriage & Family Therapist
4913 W RENO AVE
OKLAHOMA CITY, OK 73127
Oklahoma County (405) 948-4900
ANTHY TRAN
Pharmacist
4913 W RENO AVE
OKLAHOMA CITY, OK 73127
Oklahoma County (405) 948-4900
NICOLE STEARNS RN BSN
Registered Nurse (Case Management)
4913 W RENO AVE
OKLAHOMA CITY, OK 73127
Oklahoma County (405) 948-4900
LAKIN DIANE URIAS NP
Nurse Practitioner (Family)
4913 W RENO AVE
OKLAHOMA CITY, OK 73127
Oklahoma County (405) 948-4900
ROY CHACKO GEORGE D.PH.
Pharmacist
4913 W RENO AVE
OKLAHOMA CITY, OK 73127
Oklahoma County (405) 948-4900

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 Jimmie Peterson's NPI number?

The NPI number for Jimmie Peterson is 1417483405. It was assigned to this individual provider in the NPPES registry on May 11, 2017.

Where is Jimmie Peterson located?

Jimmie Peterson practices at 4913 W Reno Ave, Oklahoma City, OK 73127. The listed phone number is (405) 948-4900.

What is Jimmie Peterson's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Jimmie Peterson was last updated on December 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.