1. Home
  2. Directory
  3. Ohio
  4. Antwerp
  5. Nurse Practitioner
  6. NPI Profile

KELLEY J PETERS NP
NPI 1639573694
Nurse Practitioner - Family in Antwerp, OH

Active since October 20, 2014PECOS EnrolledAccepts Medicare Assignment
107 BUFFALO STREET, ANTWERP, OH 45813(419) 258-5641(419) 258-2711 Get Directions Write a Review

NPPES record last updated: November 8, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Nov 8, 2023, Mar 14, 2016 (2 updates tracked since 2016).

About Kelley J Peters Np NPPES

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

KELLEY J PETERS NP (NPI 1639573694) is an individual family provider in Antwerp, Ohio, licensed in Tennessee (25358) and active in the NPI registry since October 2014. She is enrolled in Medicare PECOS, maintains a secondary practice location in Knoxville, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1639573694
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKELLEY J PETERSCredential: NP
Location Address107 BUFFALO STREETAntwerp, OH 45813-1047
Mailing AddressPo Box 1047, 107 Buffalo StreetAntwerp, OH 45813-1047 · (419) 258-5641 · Fax (419) 258-2711
Phone(419) 258-5641
Fax(419) 258-2711
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateOctober 20, 2014
Last NPPES UpdateNovember 8, 20232 updates tracked since enumeration
NPPES CertifiedNovember 8, 2023
✔ NPI 1639573694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TN · 25358
Also ListedRegistered NurseTaxonomy 163W00000X · License 28145162A (IN)
Also ListedNurse PractitionerTaxonomy 363L00000X · License 71005210A (IN), COA16762 (OH)
107 BUFFALO STREET, Antwerp, OH 45813
Open in Google Maps ↗

Secondary Practice Location 1

Location 18635 Middlebrook PikeKnoxville, TN 37923-1612 · Phone (865) 824-0079 · Fax (833) 908-2101

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter Health, Ambetter of Alabama and more.Insurance ›

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

Kelley J Peters Np 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.

PECOS PAC ID8729302740
PECOS Enrollment IDI20200626000180
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.

Medicare Billing Reassignments

4

Medicare enrollment records show Kelley Peters reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Summit Medical Group, PLLC
335 mi
Family Medicine
2212 JACKSBORO PIKE
La Follette, TN 37766
  • Reassigned Medicare billing, Tennessee enrollment
  • 1,003 clinicians in this Medicare group
NPI 1376622639 (423) 566-8181
Well-Key Health, PLLC
373 mi
Urgent Care
1787 VETERANS BLVD, SUITE 101
Sevierville, TN 37862
  • Reassigned Medicare billing, Tennessee enrollment
  • 74 clinicians in this Medicare group
NPI 1114234382 (865) 428-2773
Crossroads Urgent Care PLLC
376 mi
Family Medicine
2445 MEMORIAL BLVD
Murfreesboro, TN 37129
  • Reassigned Medicare billing, Tennessee enrollment
  • 310 clinicians in this Medicare group
NPI 1366644361 (615) 864-8713
Dx Mso, PLLC
425 mi
Urgent Care
1521 GUNBARREL RD, STE 103
Chattanooga, TN 37421
  • Reassigned Medicare billing, Tennessee enrollment
  • 224 clinicians in this Medicare group
NPI 1225381148 (423) 531-0911

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, dexamethasone sodium phosphate, 1 mg J1100
Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
121 services14 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
32 services32 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
29 services29 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
23 services22 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
16 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45813 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

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 Kelley Peters's NPI number?

The NPI number for Kelley Peters is 1639573694. It was assigned to this individual provider in the NPPES registry on October 20, 2014.

Where is Kelley Peters located?

Kelley Peters practices at 107 Buffalo Street, Antwerp, OH 45813. The listed phone number is (419) 258-5641.

What is Kelley Peters's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kelley Peters enrolled in Medicare?

Yes. Kelley Peters 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 Kelley Peters's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelley Peters reassigns Medicare benefits to 4 organizations: Summit Medical Group, PLLC (La Follette, TN), Well-Key Health, PLLC (Sevierville, TN), Crossroads Urgent Care PLLC (Murfreesboro, TN) and Dx Mso, PLLC (Chattanooga, TN). 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 Kelley Peters's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelley Peters accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Kelley Peters 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 Kelley Peters was last updated on November 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.