PETERSON WELLNESS PRIMARY CARE AND PEDIATRICS, PLLC
NPI 1851062517
Clinic/Center - Primary Care in Broken Arrow, OK
About Peterson Wellness Primary Care And Pediatrics, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PETERSON WELLNESS PRIMARY CARE AND PEDIATRICS, PLLC (NPI 1851062517) is a healthcare organization registered as a primary care in Broken Arrow, Oklahoma and active in the NPI registry since September 2021. The organization holds a CLIA Waiver certificate valid through July 11, 2028 and lists Ashton Danielle Peterson, Nurse Practitioner, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Peterson Wellness Primary Care And Pediatrics, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Peterson Wellness Primary Care And Pediatrics, PLLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 37D2264309
Peterson Wellness Primary Care And Pediatric Care · Broken Arrow, OKFrequently 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 Peterson Wellness Primary Care And Pediatrics, PLLC's NPI number?
The NPI number for Peterson Wellness Primary Care And Pediatrics, PLLC is 1851062517. It was assigned to this organization in the NPPES registry on September 22, 2021.
Where is Peterson Wellness Primary Care And Pediatrics, PLLC located?
Peterson Wellness Primary Care And Pediatrics, PLLC is located at 109 W Commercial St, Broken Arrow, OK 74012. The listed phone number is (918) 724-3952.
What is Peterson Wellness Primary Care And Pediatrics, PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Peterson Wellness Primary Care And Pediatrics, PLLC enrolled in Medicare?
Yes. Peterson Wellness Primary Care And Pediatrics, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Peterson Wellness Primary Care And Pediatrics, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Peterson Wellness Primary Care And Pediatrics, PLLC. A 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 the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Peterson Wellness Primary Care And Pediatrics, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 37D2264309) is associated with this NPI, valid through July 11, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Peterson Wellness Primary Care And Pediatrics, PLLC was last updated on September 22, 2021. 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.
# Peterson Wellness Primary Care And Pediatrics, Pllc · NPI 1851062517
Primary Care organization in Broken Arrow, Oklahoma. Organization record, active in the CMS NPPES registry since September 22, 2021.
## Identity
- **NPI:** 1851062517 (Entity type: Organization)
- **Enumerated:** September 22, 2021
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Ashton Peterson, NURSE PRACTITIONER, OWNER
## Practice location
- **Address:** 109 W COMMERCIAL ST, Broken Arrow, OK 74012-4012
- **Phone:** (918) 724-3952
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 22, 2021
- **Other identifiers:** Medicaid 200833910A (OK)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1851062517) · Data from the CMS NPPES public registry.