Elizabeth Marie Peterson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05013204A Issued in IN

Practice address

15751 San Carlos Blvd Ste 4
Fort Myers, FL 33908-3315

Phone

(239) 337-2739

Fax

(239) 337-2738

NPI assigned

Oct 19, 2017

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 IN, AL2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Senior Outpatient ServicesGroup PAC ID 6507264165, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Senior Outpatient Services

  • Occupational Therapist
  • Elkhart, IN
  • NPI 1750050977

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• PT Solutions of Montgomery, LLC

  • Physical Therapist
  • Montgomery, AL
  • NPI 1073558086
  Medicare reassignment
• Concepts in Rehab Inc

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Fort Myers, FL
  • NPI 1558458273
  NPD (past)

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1043721897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15751 SAN CARLOS BLVD STE 4",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083315",
            "telephone_number": "239-337-2739",
            "fax_number": "239-337-2738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15751 SAN CARLOS BLVD STE 4",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083315",
            "telephone_number": "239-337-2739",
            "fax_number": "239-337-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-19",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT32891",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05013204A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Williams Peters, M.A., L.M.H.C.
• Sunny Peters
• Tammy M. Peters
• Brandon Joseph Peterson
• Deborah K Peterson, NP
• Mary Kay Peterson, MD
• Fedna Petit Frere
• Sasha R. Petit Frere
• Henri Petit-Monsiieur
• Michael Raymond Petrarca, M.S., A.T.C

• Physical Therapist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; 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.