Mark Peterson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT0000005441 Issued in TN

Practice address

800 S Mohawk Dr
Suite D
Erwin, TN 37650-2124

Phone

(423) 743-1245

Fax

(423) 743-2885

NPI assigned

Apr 26, 2012

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/4824/brand/1/csg/1/fhir/r4

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.

• Associated Therapy Services of Unicoi County

  • Physical Therapy Clinic/Center
  • Erwin, TN
  • NPI 1265768188
  NPD
• Mountain States Health Alliance

  • Inpatient Hospice
  • Abingdon, VA
  • NPI 1336635192
  NPD (past)

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1316205487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 WALKERS BEND RD",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376154165",
            "telephone_number": "423-743-1245",
            "fax_number": "423-743-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S MOHAWK DR",
            "address_2": "SUITE D",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376502124",
            "telephone_number": "423-743-1245",
            "fax_number": "423-743-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-26",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT0000005441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nolachucky Medical
• Sara Jean O'Daniel, DMD
• Victoria Lynn Osborne, F.N.P.
• Amy M Perkins, PHARMD
• Peterson Family Healthcare
• Shanna B Peterson, FNP
• Christopher Phillips, PT
• Pioneer Medical Associates, PC
• Ashley Danielle Powell
• Daryl Michael David Price, PHARMD

• Physical Therapist in Erwin, TN
• Providers in Erwin, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.