Active NPI
Leah Petersen, RPT
- Physical Therapist
- Shawnee Mission, KS
National Provider Identifier
1114205226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11-04131
- Practice address
- 10000 W 75TH St
Ste 121
Shawnee Mission, KS 66204-2209 - Phone
- (913) 362-7518
- NPI assigned
- Jul 25, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2010042345 | MO | |
| Physical Therapist | 225100000X | 11-04131 | KS | Primary |
Addresses
Primary practice location
10000 W 75TH St
Ste 121
Shawnee Mission, KS 66204-2209
Mailing address
11901 Rosewood St
Overland Park, KS 66209-3533
Phone (913) 498-2742
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11-04131 | KS | MD | Physical Therapist |
| 2010042345 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648771200000",
"number": "1114205226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11901 ROSEWOOD ST",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662093533",
"telephone_number": "913-498-2742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10000 W 75TH ST",
"address_2": "STE 121",
"city": "SHAWNEE MISSION",
"state": "KS",
"postal_code": "662042209",
"telephone_number": "913-362-7518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "LEAH",
"credential": "RPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-25",
"last_updated": "2022-04-01",
"certification_date": "2022-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2010042345",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KS",
"license": "11-04131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shawnee Mission, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.