Kristen Peterson, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT003395 Issued in GA

Practice address

1100 Circle 75 Pkwy SE Ste 1400
Atlanta, GA 30339-3067

Phone

(678) 403-3555

NPI assigned

Jan 13, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1336738491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 CALDWELL RD",
            "city": "BOWDON",
            "state": "GA",
            "postal_code": "301082105",
            "telephone_number": "770-880-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CIRCLE 75 PKWY SE STE 1400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393067",
            "telephone_number": "678-403-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KRISTEN",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT003395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATC LICENSE",
            "identifier": "AT003395",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristen.peterson@ptsolutions.com",
            "affiliation": "Y",
            "endpointDescription": "Secured Work Email",
            "affiliationName": "PT Solutions, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1100 Circle 75 Pkwy SE Ste 1400",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303393067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jacob Harley Peterson, DC
• Jeffrey Justin Peterson, MD
• Jenna Peterson
• Judy Garrett Peterson, RPH
• Kathryn Marie Peterson, PHD
• Kristofor Mikael Peterson, DC
• Leigh Ann Peterson, LPC, CEAP, SAP
• Mary Peterson, CRNA
• Michael Peterson, AA
• Quendall Peterson, RPH

• Athletic Trainer in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.