Active NPI
Stephanie Kay Peterson
- Massage Therapist
- Eau Claire, WI
National Provider Identifier
1427280882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 3554-046
- Practice address
- 4330 Golf Ter
Suite 209
Eau Claire, WI 54701-4683 - Phone
- (715) 835-1421
- NPI assigned
- Aug 19, 2009
- 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 | 3554-046 | WI | Primary |
Addresses
Primary practice location
4330 Golf Ter
Suite 209
Eau Claire, WI 54701-4683
Mailing address
4330 Golf Ter
Suite 209
Eau Claire, WI 54701-4683
Phone (715) 835-1421
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3554-046 | WI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250640000000",
"number": "1427280882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4330 GOLF TER",
"address_2": "SUITE 209",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547014683",
"telephone_number": "715-835-1421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4330 GOLF TER",
"address_2": "SUITE 209",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547014683",
"telephone_number": "715-835-1421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "STEPHANIE",
"middle_name": "KAY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-19",
"last_updated": "2009-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WI",
"license": "3554-046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eau Claire, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.