SUPATHA KIMBLE PETERS FNP-C
NPI 1861984445
Nurse Practitioner - Family in Fort Eustis, VA

Q: What is Supatha Peters's NPI number?

The NPI number for Supatha Peters is 1861984445. It was assigned to this individual provider in the NPPES registry on May 31, 2018.

Q: What is Supatha Peters's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Supatha Peters was last updated on November 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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 31, 2018PECOS Enrolled

576 JEFFERSON AVE, FORT EUSTIS, VA 23604(757) 314-7500 Get Directions Write a Review

NPPES record last updated: November 19, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 19, 2024, Aug 4, 2022, May 12, 2019 and 2 more (5 updates tracked since 2018).

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About Supatha Kimble Peters Fnp-c NPPES

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

SUPATHA KIMBLE PETERS FNP-C (NPI 1861984445) is an individual family provider in Fort Eustis, Virginia, licensed in Virginia (0024175296) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1861984445

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSUPATHA KIMBLE PETERSCredential: FNP-C

Location Address576 JEFFERSON AVEFort Eustis, VA 23604-1373

Mailing Address576 Jefferson AveFort Eustis, VA 23604-1373

Phone(757) 314-7500

Sole ProprietorNo

Enumeration DateMay 31, 2018

Last NPPES UpdateNovember 19, 20245 updates tracked since enumeration

NPPES CertifiedNovember 19, 2024

✔ NPI 1861984445 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in VA · 0024175296

576 JEFFERSON AVE, Fort Eustis, VA 23604

Open in Google Maps ↗

Secondary Practice Locations 4

Location 11 Jarrett White RdTripler Army Medical Center, HI 96859 · Phone (808) 433-6661

Location 21320 LaSalle AveHampton, VA 23669-3801 · Phone (757) 727-2577

Location 36600 Van Aalst Blvd Bldg 9250Fort Benning, GA 31905-2102 · Phone (762) 408-2273

Location 424 S Adams StPetersburg, VA 23803-4525 · Phone (804) 732-2180

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Supatha Kimble Peters Fnp-c 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.

Medicare Billing Reassignments

Medicare enrollment records show Supatha Peters reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Quickcare Health Inc

6.9 mi

Urgent Care

1013 UNIVERSITY BLVD STE 270-280
Suffolk, VA 23435

Reassigned Medicare billing, Virginia enrollment
4 clinicians in this Medicare group

NPI 1306320130 (757) 600-8451

Roanoke Valley Healthcare Partners, LLC

196 mi

Multi-Specialty

602 BRANDON AVE SW, SUITE 222
Roanoke, VA 24015

Reassigned Medicare billing, Virginia enrollment
101 clinicians in this Medicare group

NPI 1619274446 (540) 774-0000

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 4

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.

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

22 services11 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

21 services19 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.

21 services20 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23604 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 20

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

MS. SAMANTHA NICHOLE ROBERT LPTA

Physical Therapy Assistant

576 JEFFERSON AVE, MCDONALD ARMY HEALTH CENTER
FORT EUSTIS, VA 23604

Newport News City (757) 314-7616

KATHRYN GRACE MCCARN PT, DPT

Physical Therapist