Individual provider Active NPI

Cynthia Ann Peterson, OTR

  • Pediatric Occupational Therapist
  • Kansas City, KS
National Provider Identifier
1194869628
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
1700257 Issued in KS
Practice address
2100 Metropolitan Ave
Suite 19
Kansas City, KS 66106-3061
Phone
(913) 281-2541
Fax
(913) 281-0994
NPI assigned
Feb 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 1700257 KS Primary

Addresses

Primary practice location

2100 Metropolitan Ave
Suite 19
Kansas City, KS 66106-3061

Mailing address

PO Box 6165
Kansas City, KS 66106-0165
Phone (913) 281-2541

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

LicenseStateTypeSpecialty
1700257KSMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1194869628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6165",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661060165",
            "telephone_number": "913-281-2541",
            "fax_number": "913-281-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 METROPOLITAN AVE",
            "address_2": "SUITE 19",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661063061",
            "telephone_number": "913-281-2541",
            "fax_number": "913-281-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "KS",
            "license": "1700257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.