Blake Peterson, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2021026428 Issued in MO

Practice address

820 W Foxwood Dr
Raymore, MO 64083-9195

Phone

(816) 318-8109

NPI assigned

Jul 7, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, AZ, CA3 enrollments

Enrollment records 3

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rehab Specialists IncGroup PAC ID 7810071958, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mosaic Life Care at St Joseph Hospital, Saint Joseph, MO, CCN 260006

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: blake.peterson.p9@direct.athleticoltd.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rehab Specialists, Inc

  • Physical Therapist
  • Beverly Hills, CA
  • NPI 1487717153
  Medicare reassignment Care Compare group NPD
• Athletico LTD

  • Physical Therapist
  • Liberty, MO
  • NPI 1114449857
  Medicare reassignment NPD
• Strength Training Inc

  • Physical Therapist
  • Phoenix, AZ
  • NPI 1518925569
  Medicare reassignment NPD
• Adi Rehab, Incorporated

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1104850197
  NPD (past)
• Strength Training Inc

  • Customized Equipment (DME)
  • Phoenix, AZ
  • NPI 1356552996
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Heartland Regional Medical Center

  • General Acute Care Hospital
  • Saint Joseph, MO
  • NPI 1437259694
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1033780366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 W FOXWOOD DR",
            "city": "RAYMORE",
            "state": "MO",
            "postal_code": "640839195",
            "telephone_number": "816-318-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 W FOXWOOD DR",
            "city": "RAYMORE",
            "state": "MO",
            "postal_code": "640839195",
            "telephone_number": "816-318-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "BLAKE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-06836",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2021026428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Matthew Patterson
• Paul R. Mann, D.D.S., P.C.
• Harrison Austin Perdew, PHARMD
• Nicholaus E Perkins, LMSW
• Lisa Wilette Perry, LPC
• Kelly R. Phillips, LCSW
• Kathryn Lee Pickett, ARNP
• Elisabeth Grace Pineda-Mendez
• Meghan Lee Pitts, LPC
• Dulany Maria Potter

• Physical Therapist in Raymore, MO
• Providers in Raymore, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.