1. Home
  2. Directory
  3. Florida
  4. Cape Coral
  5. Nurse Practitioner
  6. NPI Profile

REVONDA D PETERSON ARNP
NPI 1891458683
Nurse Practitioner - Gerontology in Cape Coral, FL

Active since October 19, 2021PECOS Enrolled
5420 CHIQUITA BLVD S APT C, CAPE CORAL, FL 33914(239) 240-0040 Get Directions Write a Review

NPPES record last updated: May 11, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: May 11, 2026, Oct 19, 2021 (2 updates tracked since 2021).

About Revonda D Peterson Arnp NPPES

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

REVONDA D PETERSON ARNP (NPI 1891458683) is an individual gerontology provider in Cape Coral, Florida, licensed in Florida (11015620) and active in the NPI registry since October 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1891458683
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameREVONDA D PETERSONCredential: ARNP
Location Address5420 CHIQUITA BLVD S APT CCape Coral, FL 33914-7418
Mailing Address5420 Chiquita Blvd S Apt CCape Coral, FL 33914-7418 · (239) 240-0040
Phone(239) 240-0040
Sole ProprietorYes
Enumeration DateOctober 19, 2021
Last NPPES UpdateMay 11, 20262 updates tracked since enumeration
NPPES CertifiedOctober 19, 2021
✔ NPI 1891458683 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in FL · 11015620
5420 CHIQUITA BLVD S APT C, Cape Coral, FL 33914
Open in Google Maps ↗

Other Names 1

Professional Name (2)Revonda D Peterson

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Revonda D Peterson Arnp 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33914 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
$91.69 typical visit price
range $58.56 – $179.05
Typical copayment $22.92 (range $14.64 – $44.76)
Most-billed visit code 99203
Established Patient
$103.21 typical visit price
range $18.44 – $144.68
Typical copayment $25.80 (range $4.61 – $36.17)
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 Revonda Peterson's NPI number?

The NPI number for Revonda Peterson is 1891458683. It was assigned to this individual provider in the NPPES registry on October 19, 2021. The provider is also known as Revonda D Peterson.

Where is Revonda Peterson located?

Revonda Peterson practices at 5420 Chiquita Blvd S Apt C, Cape Coral, FL 33914. The listed phone number is (239) 240-0040.

What is Revonda Peterson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Revonda Peterson enrolled in Medicare?

Yes. Revonda Peterson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Revonda Peterson was last updated on May 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.