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KELLSEY PETERSON M.D. NPI 1487008983


NPI Information

NPI: 1487008983
Provider Name: KELLSEY PETERSON, M.D.
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

PECOS Registration: Yes

Address:
2799 W GRAND BLVD
DETROIT, MI
ZIP 48202
Phone: (800) 653-6568
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Kellsey Peterson, M.D. is a cardiovascular disease internal medicine in Detroit, MI with 8 years of experience. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. Kellsey Peterson, M.D. NPI is 1487008983. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2799 W GRAND BLVD
DETROIT, MI
ZIP 48202-608
Phone: (800) 653-6568
Fax: (313) 876-1305

The NPI 1487008983 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/20/2016 and was last updated on 9/19/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208M00000XHospitalist303757NEW YORKNo
2207R00000XInternal Medicine4301506898MICHIGANNo
3207RC0000XInternal MedicineCardiovascular Disease4301506898MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.