Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Jeffry Lynes Peterson, CRNA

Certified Registered Nurse Anesthetist in Red Bud, IL · enumerated 2007.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1164569729

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Registry record

Entity type Individual (Type 1)

Name Jeffry Lynes Peterson

Credential CRNA

Sex Male

Practice address 10117 Pine Crest Rd, Red Bud, IL, 62278

Phone (618) 282-2872

Enumeration date Jan 31, 2007

Last updated in NPPES May 29, 2026

Taxonomy & licenses

367500000X Certified Registered Nurse Anesthetist Physician Assistants & Advanced Practice Nursing Providers · License 3002489 (KY) Primary

367500000X Certified Registered Nurse Anesthetist Physician Assistants & Advanced Practice Nursing Providers · License 124294 (MO) Secondary

367500000X Certified Registered Nurse Anesthetist Physician Assistants & Advanced Practice Nursing Providers · License 209-000383 (IL) Secondary

CRNA · Certified Registered Nurse Anesthetist: An advanced practice nurse specializing in anesthesia care. About the CRNA credential

Other identifiers

Identifier	Type	State	Issuer
7424890700	Medicaid	KY	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

Where does Jeffry Peterson practice?

The practice location on file with NPPES is in Red Bud, IL. Providers can have multiple locations; NPPES lists the primary practice address.

What is the NPI number for Jeffry Peterson?

The National Provider Identifier (NPI) for Jeffry Peterson is 1164569729, a Type 1 (individual) record in the CMS NPPES registry.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2026-05-29.