Angeline M Petersen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT3198 Issued in ID

Practice address

1588 W Cayuse Creek Dr Ste 110
Meridian, ID 83646-4795

Phone

(208) 515-7575

Fax

(208) 515-7578

NPI assigned

Jun 1, 2017

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

All in Physical Therapy LLCGroup PAC ID 9537424007, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• All in Physical Therapy LLC

  • Physical Therapist
  • Meridian, ID
  • NPI 1083123251
  Medicare reassignment Care Compare group NPD
• All in Physical Therapy, LLC

  • Physical Therapist
  • Meridian, ID
  • NPI 1992539068
  NPD

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1417485590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1588 W CAYUSE CREEK DR STE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836464795",
            "telephone_number": "208-515-7575",
            "fax_number": "208-515-7578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1588 W CAYUSE CREEK DR STE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836464795",
            "telephone_number": "208-515-7575",
            "fax_number": "208-515-7578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "ANGELINE",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT3198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO LICENSE",
            "identifier": "PT3198",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kerrie L Petech, R.N. ARNP-CNP
• David L Peterman, MD
• Angela Lynn Peters, BSIS
• Marcy Lynn Peters, LCSW
• Nicki Jo Peters, NP-C
• Ami Peterson, LPC
• Andrew Peterson, DPT
• Anne M Peterson
• Christian Peterson, DDS
• James Christian Peterson, MSPT

• Physical Therapist in Meridian, ID
• Providers in Meridian, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.