Katelyn Amanda Petersen

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

Practice address

43507 N Ironwood Dr
San Tan Valley, AZ 85140-9312

Phone

(480) 757-2253

NPI assigned

Jun 22, 2022

Sex

Female

Sole proprietor

No

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": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1497486153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 W ALABAMA LN",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851426157",
            "telephone_number": "480-692-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43507 N IRONWOOD DR",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851409312",
            "telephone_number": "480-757-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "KATELYN",
        "middle_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perry Health
• Deana Perry
• Perseus Learning Center LLC
• Melissa S Peteris, CPM, LM, LVN
• Bryce Petersen, PT, D.P.T.
• Debra Theresa Peterson I, LPN
• Phoenix Star Behavioral Healthcare LLC
• Stevenson Pierre
• Kelsey Lynn Pile
• Pinal County Arizona

• Speech-Language Assistant in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Speech-Language Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.