Susan Kay Peterson, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501303188 Issued in MI

Practice address

2849 Michigan St NE Ste 100
Grand Rapids, MI 49506-1216

Phone

(616) 956-0400

NPI assigned

Feb 16, 2024

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

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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.

• Owens Physical Therapy Specialists, LLC

  • Physical Therapist
  • Grand Rapids, MI
  • NPI 1629220835
  Medicare reassignment NPD

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1306601695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2849 MICHIGAN ST NE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061216",
            "telephone_number": "616-956-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2849 MICHIGAN ST NE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061216",
            "telephone_number": "616-956-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SUSAN",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501303188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Peterson
• Neil T Peterson, MD
• Rebecca Peterson, FNP-C
• Sarah Frances Peterson, MD
• Scott Jeffrey Peterson
• Tanya Peterson
• Tayler N Peterson
• Theresa Ann Peterson
• Thomas Peterson, M.D.
• Thomas Peterson

• Physical Therapist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.