Elizabeth Ann Petersen

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

164860 Issued in OK

Practice address

3801 W 52ND PL
Tulsa, OK 74107-8919

Phone

(918) 600-6825

NPI assigned

Jun 8, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Beth Lillard Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1447827464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 W 52ND PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741078919",
            "telephone_number": "918-600-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 W 52ND PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741078919",
            "telephone_number": "918-600-6825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OK",
            "license": "164860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETH",
            "last_name": "LILLARD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Precious Peters
• Shannen Michon Peters
• Sherelle Mignon Peters
• Victoria Lee Peters, LPC
• Walter James Peters Jr., MD
• Madison Paige Petersen, BSW
• Wallis Petersen
• Peterson Chiropractic
• Alison Cornelius Peterson, LPC-C
• Amanda Diane Peterson, PHARMD

• Massage Therapist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Massage Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.