Peterson Therapy Services, Inc

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

PETERSON THERAPY SERVICES, INC

Practice address

545 Lincoln Dr
Idaho Falls, ID 83401

Phone

(208) 584-1141

Fax

(888) 501-2591

NPI assigned

Jul 31, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marissa Peterson, MA/CCC-SLPNPI 1669633590

Title

Owner

Phone

(208) 584-1141

Specialties & licenses 4

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marissa Peterson, MA/CCC-SLP

  • Speech-Language Pathologist
  • Idaho Falls, ID
  • NPI 1669633590
  NPD (past) Authorized official

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533081600000",
    "number": "1427536614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 LINCOLN DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014118",
            "telephone_number": "208-584-1141",
            "fax_number": "888-501-2591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 LINCOLN DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83401",
            "telephone_number": "208-584-1141",
            "fax_number": "888-501-2591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON THERAPY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-08-01",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-584-1141",
        "authorized_official_credential": "MA/CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iris Peter, PA-C
• Ryne Shawn Peters, DO
• Betsy Pack Petersen, LMSW
• Emily Petersen
• Peterson Speech Therapy
• Chase Peterson, DPT
• Chelsea Joan Peterson, MOTR/L
• Corene Peterson, LCSW
• Malik Peterson, DO, DO
• Emily Peterson

• Speech-Language Pathologist in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Speech-Language Pathologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; 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.