Jessie L Peterson, PT, DPT, LAT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

7351 Prairie Falcon Rd Ste 100
Las Vegas, NV 89128-0820

Phone

(702) 968-0520

NPI assigned

May 18, 2022

Last updated

Jun 7, 2022By the provider in NPPES

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

Other names 1

• Jessie L Morwood Former name

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family and Sports Physical TherapyGroup PAC ID 1355320359, 3 clinicians

Affiliated Physical TherapyGroup PAC ID 1951453075, 47 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Affiliated Physical Therapy

  • Physical Therapist
  • North Las Vegas, NV
  • NPI 1669607156
  Medicare reassignment Care Compare group NPD
• Family and Sports Physical Therapy

  • Physical Therapy Clinic/Center
  • Las Vegas, NV
  • NPI 1912082140
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1194462481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5271 MINERAL LAKE DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891228345",
            "telephone_number": "702-468-1266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7351 PRAIRIE FALCON RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280820",
            "telephone_number": "702-968-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JESSIE",
        "middle_name": "L",
        "credential": "PT, DPT, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-18",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NV",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSIE",
            "last_name": "MORWOOD",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gabrielle Peterson, DO
• Gabrielle Irene Peterson, APRN
• Graciela Peterson
• Holly Deeann Peterson, RN
• Jennifer Peterson
• Julie Lynn Peterson, SLP
• Keaton Peterson
• Kelly Ann Peterson, APRN, FNP-BC
• Kristen Noel Peterson
• Kurt Robert Peterson, D.O

• Physical Therapist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.