Active NPI
Bridget Peterson
- Occupational Therapist
- Robbinsdale, MN
National Provider Identifier
1033545322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 102773
- Practice address
- 3815 W Broadway Ave
Robbinsdale, MN 55422-2207 - Phone
- (612) 332-4262
- NPI assigned
- Sep 19, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 102773 | MN | Primary |
Addresses
Primary practice location
3815 W Broadway Ave
Robbinsdale, MN 55422-2207
Mailing address
4733 Ewing Ave S
Minneapolis, MN 55410-1747
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102773 | MN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379548800000",
"number": "1033545322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4733 EWING AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554101747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3815 W BROADWAY AVE",
"city": "ROBBINSDALE",
"state": "MN",
"postal_code": "554222207",
"telephone_number": "612-332-4262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "BRIDGET",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-19",
"last_updated": "2013-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "102773",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Robbinsdale, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.