Jared L Peterson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7495 Issued in MN

Practice address

2530 Broadway Ave N
Rochester, MN 55906-4594

Phone

(507) 259-7570

Fax

(888) 624-3107

NPI assigned

Apr 10, 2009

Sex

Male

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

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

{
    "created_epoch": "1239321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513209600000",
    "number": "1194968842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 BROADWAY AVE N",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559061042",
            "telephone_number": "507-259-7570",
            "fax_number": "888-624-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 BROADWAY AVE N",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559064594",
            "telephone_number": "507-259-7570",
            "fax_number": "888-624-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JARED",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-10",
        "last_updated": "2017-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10801-024",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "7495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erik Peterson
• Gary Daniel Peterson, DO
• Gregory S Peterson, MD
• Heidi Ann Peterson, CNP
• Jane Maria Peterson, C.R.N.A.
• Jess Friedrich Peterson, M.D.
• Joshua Allen Peterson, MD
• Kari K Peterson, CRNA
• Kathleen Peterson, MA, LPCC
• Kelly Peterson

• Physical Therapist in Rochester, MN
• Providers in Rochester, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2017; 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.