DR. CAITLIN GANNON PETERSON DO
NPI 1760742530
Pediatrics - Pediatric Nephrology in Norfolk, VA

Q: What is Caitlin Peterson's NPI number?

The NPI number for Caitlin Peterson is 1760742530. It was assigned to this individual provider in the NPPES registry on May 25, 2012. The provider is also known as Caitlin Rebecca Gannon Do.

Q: What is Caitlin Peterson's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Nephrology, with taxonomy code 2080P0210X.

Q: When was this NPI record last updated?

The NPPES record for Caitlin Peterson was last updated on June 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since May 25, 2012PECOS EnrolledAccepts Medicare Assignment

601 CHILDRENS LN, NORFOLK, VA 23507(757) 668-7244 Get Directions Write a Review

NPPES record last updated: June 26, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 26, 2024, Jun 10, 2024, Nov 11, 2021 and 2 more (5 updates tracked since 2018).

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About Dr. Caitlin Gannon Peterson Do NPPES

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

DR. CAITLIN GANNON PETERSON DO (NPI 1760742530) is an individual pediatric nephrology provider in Norfolk, Virginia, licensed in Virginia (0102208511) and active in the NPI registry since May 2012. She is enrolled in Medicare PECOS and is a graduate of Arizona College Of Osteopathic Medicine Mid Western University (2012).

NPPES Registry Identity

NPI1760742530

Entity TypeIndividualFemale

Primary Taxonomy2080P0210X

Provider Legal NameDR. CAITLIN GANNON PETERSONCredential: DO

Location Address601 CHILDRENS LNNorfolk, VA 23507-1910

Mailing Address601 Childrens LnNorfolk, VA 23507-1910 · (757) 668-7244 · Fax (757) 668-9814

Phone(757) 668-7244

Sole ProprietorYes

Medical School CMSArizona College Of Osteopathic Medicine Mid Western UniversityGraduated 2012

Enumeration DateMay 25, 2012

Last NPPES UpdateJune 26, 20245 updates tracked since enumeration

NPPES CertifiedJune 26, 2024

✔ NPI 1760742530 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0210X

Licenses✔ Licensed in VA · 0102208511✔ Licensed in UT · 10784090-1204

Definition

A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

601 CHILDRENS LN, Norfolk, VA 23507

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Other Names 1

Former Name (1)Caitlin Rebecca Gannon Do

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Caitlin Gannon Peterson Do 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 ID6709024599

PECOS Enrollment IDI20240520002207

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.

Referred Medical Equipment & Supplies CMS DME claims 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg J7503

Treatment-Chemotherapy · category RH002N

1 supplier12 claims3,203 services$1.23 avg. paid by Medicare

Tacrolimus, immediate release, oral, 1 mg J7507

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier33 claims4,290 services$0.33 avg. paid by Medicare

Mycophenolate mofetil, oral, 250 mg J7517

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier11 claims1,130 services$0.21 avg. paid by Medicare

Mycophenolic acid, oral, 180 mg J7518

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier32 claims3,450 services$1.01 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511

Treatment-Chemotherapy · category RH012N

1 supplier29 claims29 services$18.95 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512

Treatment-Chemotherapy · category RH012N

1 supplier52 claims80 services$12.64 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

BELINDA JAMES-PETERSEN CPNP

Nurse Practitioner (Pediatrics)