Amanda Petersen, CBE

Primary specialty

Health EducatorTaxonomy code 174H00000X

Practice address

103 E Macarthur Ave
Bloomington, IL 61701-5234

Phone

(309) 336-3265

Fax

(309) 336-3265

NPI assigned

Oct 28, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1351382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351382400000",
    "number": "1487908547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 E MACARTHUR AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617015234",
            "telephone_number": "309-336-3265",
            "fax_number": "309-336-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 E MACARTHUR AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617015234",
            "telephone_number": "309-336-3265",
            "fax_number": "309-336-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "AMANDA",
        "credential": "CBE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-28",
        "last_updated": "2012-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher G Perkins, L.C.P.C.
• Persimmon Tree Counseling, LLC
• Stacie Peters
• Petersen Health Operations, LLC (Bloomington Rehabiliation & Health Care Center)
• Petersen Health Operations, LLC (Bloomington Rehabilitation & Health Care Center)
• Geneva A. Petersen, CNP
• Scott Mathew Peterson, DDS, MS
• Cade A Petrie
• Nikola Petrovic, DMD
• Kelly Petrovics

• Health Educator in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Health Educator in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2012; 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.