Active NPI
Melissa R Peters, PT, DPT
- Physical Therapist
- Centralia, WA
National Provider Identifier
1275955924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 60475605
- Practice address
- 917 S Scheuber Rd
Centralia, WA 98531 - Phone
- (360) 736-9384
- NPI assigned
- Jan 15, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12572-24 | WI | |
| Physical Therapist | 225100000X | 60475605 | WA | Primary |
Addresses
Primary practice location
917 S Scheuber Rd
Centralia, WA 98531
Mailing address
2921 23Rd St
Kenosha, WI 53140-1720
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60475605 | WA | MD | Physical Therapist |
| 12572-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531612800000",
"number": "1275955924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2921 23RD ST",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531401720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "917 S SCHEUBER RD",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "98531",
"telephone_number": "360-736-9384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "MELISSA",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-15",
"last_updated": "2018-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "12572-24",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "60475605",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centralia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.