Cody Petersen, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

60045899 Issued in WA

Practice address

316 E McLeod Rd Ste 101
Bellingham, WA 98226-6491

Phone

(360) 734-5410

NPI assigned

Jun 26, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498435200000",
    "number": "1215457601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S 34TH ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982256057",
            "telephone_number": "360-927-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 E MCLEOD RD STE 101",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982266491",
            "telephone_number": "360-734-5410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "CODY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-26",
        "last_updated": "2017-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "60045899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robbyn Peters Bennett, MA
• Anna Marie Peters, NURSE PRACTITIONER
• Kimberly Ann Peters, PH.D., CCC-A/SLP
• Melissa Peters, MA 60691509
• Sabra Peters, PHARMD
• Mark Linton Petersen, MS
• Elke Peterson, DPT
• Kyle Peterson
• Marissa Michelle Peterson
• Matthew R Peterson, MD

• Physical Therapy Assistant in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.