Teresa Petersen, PT, MS, PCS

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

11-00490 Issued in KS

Practice address

6600 College Blvd
Suite 307
Overland Park, KS 66211-1939

Phone

(913) 345-1997

Fax

(913) 345-1990

NPI assigned

Jan 26, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368576000000",
    "number": "1467508176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 COLLEGE BLVD",
            "address_2": "SUITE 307",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111939",
            "telephone_number": "913-345-1997",
            "fax_number": "913-345-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 COLLEGE BLVD",
            "address_2": "SUITE 307",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111939",
            "telephone_number": "913-345-1997",
            "fax_number": "913-345-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "TERESA",
        "credential": "PT, MS, PCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2013-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "KS",
            "license": "11-00490",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MO",
            "license": "2004034162",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "485072409",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100359840B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Michele Peters, MD, MS
• Christon Alexis Petersen, LPC
• Corrin Petersen, LMFT
• Hilary A Petersen, MD
• Shane Petersen
• Cynthia Sandquist Peterson, P.T.
• Elizabeth Sorrells Peterson, MD
• Grace Katherine Peterson, LMLP-T
• Kayla Marie Peterson, MS-CCC-SLP
• Lori D Peterson

• Pediatric Physical Therapist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Pediatric Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.