Peterson Sports Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PETERSON SPORTS THERAPY LLC

Practice address

4 State Rd
Danvers, MA 01923-2567

Phone

(978) 774-3400

Fax

(978) 774-5883

NPI assigned

Mar 1, 2021

Organization subpart

No

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

Authorized official

Name

Stacy M Peterson, D.O.NPI 1952416489

Title

Owner/Practice Manager

Phone

(978) 774-4000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Joseph Lovett, PT

  • Physical Therapist
  • Danvers, MA
  • NPI 1215258942
  Medicare reassignment NPD
• Stacy Peterson, D.O.

  • Emergency Medicine Physician
  • Dayton, OH
  • NPI 1952416489
  NPD Authorized official
• Douglas Edward Peterson, DO

  • Orthopaedic Surgery Physician
  • Danvers, MA
  • NPI 1477535896
  NPD (past)

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1104410216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 STATE RD",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019232567",
            "telephone_number": "978-774-3400",
            "fax_number": "978-774-5883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 STATE RD",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019232567",
            "telephone_number": "978-774-3400",
            "fax_number": "978-774-5883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON SPORTS THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PRACTICE MANAGER",
        "authorized_official_telephone_number": "978-774-4000",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imogen Perry
• Scott William Perry, RPH
• Sydney Gabrielle Perry, M.ED
• Alexa Peters
• Peterson Orthopedics LLC
• Douglas Edward Peterson, DO
• Stephanie Petillo
• Layne Petrie, M.ED., BCBA
• Madalyn Petrillo, DPT
• Anna E. Petropoulos, M.D., F.R.C.S.

• Physical Therapist in Danvers, MA
• Providers in Danvers, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.