Active NPI
Christine Sue Peterson, COTA
- Occupational Therapy Assistant
- Seymour, WI
National Provider Identifier
1316110562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1642-027
- Practice address
- W 1587 County Highway Ee
Seymour, WI 54165 - Phone
- (920) 833-7346
- NPI assigned
- Apr 9, 2008
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1642-027 | WI | Primary |
Addresses
Primary practice location
W 1587 County Highway Ee
Seymour, WI 54165
Mailing address
W 1587 County Highway Ee
Seymour, WI 54165
Phone (920) 833-7346
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 |
|---|---|---|---|
| 1642-027 | WI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207699200000",
"number": "1316110562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W 1587 COUNTY HIGHWAY EE",
"city": "SEYMOUR",
"state": "WI",
"postal_code": "54165",
"telephone_number": "920-833-7346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W 1587 COUNTY HIGHWAY EE",
"city": "SEYMOUR",
"state": "WI",
"postal_code": "54165",
"telephone_number": "920-833-7346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "CHRISTINE",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-09",
"last_updated": "2008-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WI",
"license": "1642-027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seymour, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.