Active NPI
Holly Peterson
- Massage Therapist
- Shakopee, MN
National Provider Identifier
1376082495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Practice address
- 1755 17TH Ave E
Shakopee, MN 55379-3372 - Phone
- (952) 445-5250
- Fax
- (952) 445-5350
- NPI assigned
- Feb 22, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | Primary |
Addresses
Primary practice location
1755 17TH Ave E
Shakopee, MN 55379-3372
Mailing address
1755 17TH Ave E
Shakopee, MN 55379-3372
Phone (952) 445-5250
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487721600000",
"number": "1376082495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1755 17TH AVE E",
"city": "SHAKOPEE",
"state": "MN",
"postal_code": "553793372",
"telephone_number": "952-445-5250",
"fax_number": "952-445-5350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1755 17TH AVE E",
"city": "SHAKOPEE",
"state": "MN",
"postal_code": "553793372",
"telephone_number": "952-445-5250",
"fax_number": "952-445-5350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "HOLLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-22",
"last_updated": "2017-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shakopee, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.