Michelle Peterson, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

104725 Issued in MN

Practice address

9220 Bass Lake Rd Ste 260
New Hope, MN 55428-3019

Phone

(763) 533-0363

NPI assigned

Nov 11, 2014

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)

Enrolled

State licenses

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

{
    "created_epoch": "1415664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415664000000",
    "number": "1508262056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9220 BASS LAKE RD STE 260",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554283019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9220 BASS LAKE RD STE 260",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554283019",
            "telephone_number": "763-533-0363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MICHELLE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-11",
        "last_updated": "2014-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MN",
            "license": "104725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Suzanne Perzel, LICSW
• Amanda Leigh Peterson, MA, CTRS, LMFT
• Blaire Peterson
• Eric Peterson, DDS
• Grant Peterson
• Paul S. Peterson
• Treya Pettit
• Linda Nang Phanthavong, LICSW
• Jason Wendell Phillips, D.C.
• Pioneer Dental, P.a.

• Pediatric Occupational Therapist in New Hope, MN
• Providers in New Hope, MN by specialty
• Pediatric Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2014; 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.