Active NPI
Samantha Peterson
- Physical Therapist
- Fort Riley, KS
National Provider Identifier
1245649268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2014027151
- Practice address
- 650 Huebner Rd
Fort Riley, KS 66442-4030 - Phone
- (785) 239-3627
- NPI assigned
- Aug 4, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2014027151 | MO | Primary |
Addresses
Primary practice location
650 Huebner Rd
Fort Riley, KS 66442-4030
Mailing address
650 Huebner Rd
Fort Riley, KS 66442-4030
Phone (785) 239-3627
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2014027151 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724630400000",
"number": "1245649268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 HUEBNER RD",
"city": "FORT RILEY",
"state": "KS",
"postal_code": "664424030",
"telephone_number": "785-239-3627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 HUEBNER RD",
"city": "FORT RILEY",
"state": "KS",
"postal_code": "664424030",
"telephone_number": "785-239-3627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-04",
"last_updated": "2024-08-26",
"certification_date": "2024-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2014027151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Riley, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.