Active NPI
Angela Renee Petersen, P.T.
- Physical Therapist
- Omaha, NE
National Provider Identifier
1346210945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2123
- Practice address
- 2725 S 144TH St
Omaha, NE 68144-5243 - Phone
- (402) 637-0750
- Fax
- (402) 637-0754
- NPI assigned
- Jan 25, 2006
- 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 | 2123 | NE | Primary |
Addresses
Primary practice location
2725 S 144TH St
Omaha, NE 68144-5243
Mailing address
2725 S 144TH St
Omaha, NE 68144-5243
Phone (402) 637-0750
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 |
|---|---|---|---|
| 2123 | NE | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Excel Rehabilitation Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Omaha, NE
- NPI 1306805981
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188259200000",
"number": "1346210945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2725 S 144TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681445243",
"telephone_number": "402-637-0750",
"fax_number": "402-637-0754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2725 S 144TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681445243",
"telephone_number": "402-637-0750",
"fax_number": "402-637-0754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "ANGELA",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-25",
"last_updated": "2007-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "2123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.