Kendra Peeters, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10651 Issued in MN

Practice address

311 Jefferson St N
Wadena, MN 56482-1308

Phone

(218) 631-7475

NPI assigned

Feb 6, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kendra Coleman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Mahube-Otwa Community Action Partnership

  • Non-Surgical Family Planning Clinic/Center
  • Detroit Lakes, MN
  • NPI 1588939276
  NPD (past)

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1306478441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51761 115TH ST",
            "city": "MENAHGA",
            "state": "MN",
            "postal_code": "564642083",
            "telephone_number": "218-205-1826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 JEFFERSON ST N",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564821308",
            "telephone_number": "218-631-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEETERS",
        "first_name": "KENDRA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-06",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDRA",
            "last_name": "COLEMAN",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lecia Parker
• Matthew Dean Parker, CCC-SLP
• John S Pate, M.D.
• Shana Marie Pazdernik-Hensch, PA
• Jordana Pearson
• Peoples Express, Inc.
• Dave W Peters, R.PH.
• Diane M Peters, R.PH.
• Kristine Danielle Peterson
• Tabitha Ann Petrowski, MS, CCC-SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; 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.