Bryce Petersen, PT, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

LPT-30464 Issued in AZ

Practice address

2510 E Hunt Hwy Ste 27
San Tan Valley, AZ 85143-5208

Phone

(480) 618-0480

Fax

(480) 618-0481

NPI assigned

Jan 17, 2019

Last updated

Jul 19, 2021By the provider in NPPES

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

Practice roles

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

• Hydro Air Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Gilbert, AZ
  • NPI 1528816147
  NPD Authorized official

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1053885418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 E HUNT HWY STE 27",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851435208",
            "telephone_number": "480-618-0480",
            "fax_number": "480-618-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 E HUNT HWY STE 27",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851435208",
            "telephone_number": "480-618-0480",
            "fax_number": "480-618-0481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36397 N Gantzel Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "San Tan Valley",
            "state": "AZ",
            "postal_code": "851407336",
            "country_code": "US",
            "telephone_number": "480-567-2987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "BRYCE",
        "credential": "PT, D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-17",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-30464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Susan Perez, MS CCC SLP
• Perry Health
• Deana Perry
• Perseus Learning Center LLC
• Melissa S Peteris, CPM, LM, LVN
• Katelyn Amanda Petersen
• Debra Theresa Peterson I, LPN
• Phoenix Star Behavioral Healthcare LLC
• Stevenson Pierre
• Kelsey Lynn Pile

• Physical Therapist in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.