Jeremy Thomas Peterson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P16865 Issued in NC

Practice address

104A Huffman Mill Rd
Burlington, NC 27215-5113

Phone

(336) 270-3611

NPI assigned

Feb 7, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1043758378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "919-258-2714",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104A HUFFMAN MILL RD",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272155113",
            "telephone_number": "336-270-3611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 William Penn Plz",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277042150",
            "country_code": "US",
            "telephone_number": "919-220-5255",
            "fax_number": "919-313-1276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JEREMY",
        "middle_name": "THOMAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-07",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P16865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• August Richard Peters IV, RPH
• Lisa Petersen
• Ruth Petersen, MD
• Amber Lee Peterson, LCSWA
• Jamie Jo Peterson, DDS
• Samantha Cates Pexa, DPT, ATC
• Pharaohs Pharmacy Inc (Pharaohs Pharmacy)
• Pharm-Save, Inc. (Neil Medical Group-Burlington)
• John Pharo, MSW, LCSW
• Katherine Piilani Phillips, FNP

• Physical Therapist in Burlington, NC
• Providers in Burlington, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.