Kaitlin Petersen, MOT, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

2020035472 Issued in MO

Practice address

324 Jungermann Rd
Saint Peters, MO 63376-5350

Phone

(636) 928-5327

NPI assigned

Dec 19, 2020

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)

Not enrolled

State licenses

Practice roles

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.

• Leaps and Bounds, Inc.

  • Occupational Therapist
  • Saint Peters, MO
  • NPI 1205017498
  NPD (past)

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

{
    "created_epoch": "1608336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608336000000",
    "number": "1366038754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 FORSYTH BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631052116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 JUNGERMANN RD",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633765350",
            "telephone_number": "636-928-5327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "KAITLIN",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-19",
        "last_updated": "2020-12-19",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MO",
            "license": "2020035472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bria Penilton
• Brenton Pennicooke, MD
• Jill E Peper, COTA/L
• Kali Jacklyn Perry, MOT, OTR/L
• Nicole A Peters, PLPC
• Janelle C Peterson, D.D.S.
• Robert H Peterson, DDS
• Sheri Lynn Petruso, MSW, LCSW
• Caitlin Amanda Petry, MSN, FNP-C
• Erik Michael Peyton

• All providers in Saint Peters, MO
• Pediatric Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2020; 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.