Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1225276124 Individual Practitioner Female Practitioner

Kelli Ann Peterson , RN

Licensed Practical Nurse • Pendleton, OR

Professional Overview & Biography Verified Profile Summary

Kelli Peterson, RN is a registered healthcare professional specializing in Licensed Practical Nurse in Pendleton, OR. Practice services are available at 73265 CONFEDERATED WAY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

73265 Confederated Way

Pendleton, OR 97801

Telephone 5419669830
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Pendleton, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
6 Specialists

Practicing in Pendleton, OR (741 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License OR 200843278RN

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
171037 (OR)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Cody Cimmiyotti

Peer Specialist

NPI 1003506429
NPI 1013107515

Doctor of Dental Medicine

Ian Sampson

Peer Specialist

NPI 1013403286
Amy Allen , RN

Registered Nurse

NPI 1013792696

Registered Nurse

Allan Jio

Pharmacist

NPI 1013928563
NPI 1033492822

Registered Pharmacist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active January 30, 2009

NPI status registered as active in NPPES database

📍
Updated Practice Location January 30, 2009

Registered at 73265 CONFEDERATED WAY, PENDLETON, OR 97801 (Tel: 5419669830)

📍
Updated Business Mailing Address January 30, 2009

Registered at 1011 SW 30TH, PENDLETON, OR 97801 (Tel: 5413109100)

👤
Provider Name / Credentials Updated January 30, 2009

Recorded as KELLI PETERSON, RN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 30, 2009

Licensed Practical Nurse (License #200843278RN in OR)

🟢
Initial NPI Registration & Enumeration January 30, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1225276124
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 30, 2009
Last Update: January 30, 2009
Sole Proprietor: No

Mailing Address

1011 Sw 30th

Pendleton, OR 97801

Phone: 5413109100

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.