Brian L Peterson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12413-24 Issued in WI

Practice address

2820 Roosevelt Rd
Marinette, WI 54143-3834

Phone

(715) 735-5225

Fax

(715) 732-5388

NPI assigned

Sep 11, 2013

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

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Wisconsin School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oconto Hospital and Medical Center IncGroup PAC ID 2163461781, 217 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bpeterson175439@direct.thedacare.org

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.

• Oconto Hospital & Medical Center Inc

  • Critical Access Hospital
  • Oconto, WI
  • NPI 1356373302
  Medicare reassignment Care Compare group NPD
• Bellin Memorial Hospital Inc

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473
  Medicare reassignment NPD
• Bellin Memorial Hospital Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Green Bay, WI
  • NPI 1275874869
  NPD
• Oconto Hospital & Medical Center Inc

  • Rural Health Clinic/Center
  • Suring, WI
  • NPI 1104418037
  NPD
• Oconto Hospital & Medical Center, Inc.

  • Rural Health Clinic/Center
  • Crivitz, WI
  • NPI 1174971725
  NPD
• The Neuroscience Group of Northeast Wisconsin SC

  • Neurological Surgery Physician
  • Neenah, WI
  • NPI 1578516803

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1144655937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 ROOSEVELT RD",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541433834",
            "telephone_number": "715-735-5225",
            "fax_number": "715-732-5388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 Arbutus Ave",
            "address_purpose": "LOCATION",
            "city": "Oconto",
            "state": "WI",
            "postal_code": "541532004",
            "country_code": "US",
            "telephone_number": "920-835-1100",
            "fax_number": "920-835-1099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "744 S Webster Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013505",
            "country_code": "US",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "218 S Hwy 141",
            "address_purpose": "LOCATION",
            "city": "Crivitz",
            "state": "WI",
            "postal_code": "541141677",
            "country_code": "US",
            "telephone_number": "715-854-7761",
            "fax_number": "715-854-7785",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "107 E Highland Dr",
            "address_purpose": "LOCATION",
            "city": "Oconto Falls",
            "state": "WI",
            "postal_code": "541541002",
            "country_code": "US",
            "telephone_number": "920-846-3092",
            "fax_number": "920-846-8313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "BRIAN",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-11",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12413-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allie Parthie, DDS
• Peace Counseling & Support Services LLC
• Jennifer Pentek, DPT
• Tehya Rane Pepin, RDH
• Anna Perez-Pelaez, RN
• Kim A Peterson, RN
• Marsha Jean Peterson, LPN
• Matayah Morgan Pethke, DPT
• Stephanie Phillips
• Shirley Ann Pisani, COTA

• Physical Therapist in Marinette, WI
• Providers in Marinette, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.