Jennifer A Petersen, O.T.R.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056-010596 Issued in IL

Practice address

324 Roxbury Rd
Rockford, IL 61107-5090

Phone

(815) 381-7431

Fax

(815) 381-7498

NPI assigned

Apr 15, 2014

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Empowerme Rehabilitation Missouri LLC

  • Multi-Specialty Clinic/Center
  • Prairie Village, KS
  • NPI 1205334521

  Occupational Therapist

  NPD
• Empowerme Rehabilitation Missouri LLC

  • Rehabilitation Clinic/Center
  • Columbia, MO
  • NPI 1558932327

  Occupational Therapist

  NPD
• Empowerme Wellness Kansas City, LLC

  • Multi-Specialty Clinic/Center
  • Prairie Village, KS
  • NPI 1124619697
  NPD
• Empowerme Wellness Kansas City, LLC

  • Rehabilitation Clinic/Center
  • Liberty, MO
  • NPI 1174299044
  NPD

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1144649435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 78534",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53278",
            "telephone_number": "815-381-7431",
            "fax_number": "815-381-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075090",
            "telephone_number": "815-381-7431",
            "fax_number": "815-381-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "O.T.R.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057-002477",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056-010596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia R Pesavento, D.M.D.
• Petalber Therapy Services
• Catharin Peters, APRN
• Chloe Peters
• Kelly Anne Peters, DPT
• Gary Phillip Peterson, PHARMD
• James Michael Peterson
• Jean Frances Peterson, MS, CDS
• Mark Theodore Peterson, NAPRAPATH
• Nathan Reginald Peterson, DPT

• Occupational Therapist in Rockford, IL
• Providers in Rockford, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.