Mary C Peterson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2051 Issued in TN

Practice address

756 Ridge Lake Blvd
Ste 205
Memphis, TN 38120-9445

Phone

(901) 758-2377

Fax

(990) 175-8110

NPI assigned

Feb 27, 2006

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1346216678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7464 WINCHESTER RD",
            "address_2": "STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381252205",
            "telephone_number": "901-758-2377",
            "fax_number": "990-175-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "756 RIDGE LAKE BLVD",
            "address_2": "STE 205",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209445",
            "telephone_number": "901-758-2377",
            "fax_number": "990-175-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MARY",
        "middle_name": "C",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "2051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Nicole Peterson, DPT
• April Linnett Peterson, PHARMD
• Casey Crump Peterson, NP-C
• Hannah Peterson, PHARMD
• Lori Peterson
• Matthew Peterson, DPT
• Tierany Marie Peterson, BSW
• Yonique Petrece Petgrave, M.D.
• Carolyn Petr
• Lindsey Petrelle

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; 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.