Active NPI
Janis Kaitlin Peterson, DPT
- Physical Therapist
- Prospect, KY
National Provider Identifier
1316581564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 007850
- Practice address
- 6005 Timber Ridge Dr
Prospect, KY 40059-8134 - Phone
- (502) 292-0800
- Fax
- (502) 292-0400
- NPI assigned
- Oct 31, 2019
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 007850 | KY | Primary |
Addresses
Primary practice location
6005 Timber Ridge Dr
Prospect, KY 40059-8134
Mailing address
PO Box 5629
Evansville, IN 47716-5629
Phone (812) 759-7476
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007850 | KY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572480000000",
"number": "1316581564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5629",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477165629",
"telephone_number": "812-759-7476",
"fax_number": "812-401-3259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6005 TIMBER RIDGE DR",
"city": "PROSPECT",
"state": "KY",
"postal_code": "400598134",
"telephone_number": "502-292-0800",
"fax_number": "502-292-0400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "JANIS",
"middle_name": "KAITLIN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-31",
"last_updated": "2019-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "007850",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prospect, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.