Mitchell Taylor Peterson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8331271-2401 Issued in UT

Practice address

1050 E South Temple
Salt Lake City, UT 84102-1507

Phone

(801) 350-4111

NPI assigned

Apr 4, 2013

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Physician Group of Utah Inc

  • Specialist
  • South Jordan, UT
  • NPI 1477676930
  NPD

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365033600000",
    "number": "1295078509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 E SOUTH TEMPLE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021507",
            "telephone_number": "801-350-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 E SOUTH TEMPLE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021507",
            "telephone_number": "801-350-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MITCHELL",
        "middle_name": "TAYLOR",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-04",
        "last_updated": "2013-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "8331271-2401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621795214",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• McKenzie Peterson
• Megan Jill Peterson
• Michael Peterson, MD
• Michael S Peterson, O.D.
• Micheala Peterson
• Myranda Peterson, LCSW
• Norma J Peterson, CRNA
• Paula Ruth Peterson, APRN
• Penny L Peterson, LCSW
• Rachelle Nora Peterson

• Physical Therapist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; 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.