Kathryn Petersen-Thompson, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

LL82955 Issued in SC

Practice address

853 N Church St Ste 510
Spartanburg, SC 29303-3077

Phone

(864) 560-6193

NPI assigned

Jul 22, 2019

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

• Kathryn Petersen Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1528611191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 RISEN STAR DR",
            "city": "BOILING SPRINGS",
            "state": "SC",
            "postal_code": "293168004",
            "telephone_number": "435-592-9631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 N CHURCH ST STE 510",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033077",
            "telephone_number": "864-560-6193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN-THOMPSON",
        "first_name": "KATHRYN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL82955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "PETERSEN",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Brittonni Thorne Perry, RD
• Elizabeth Ann Perry, PA-C
• Perspectives Counseling Services, LLC
• Jennifer Lynn Perugini, MD
• Brady Michael Peters
• Nannette Marie Petersen, D.O.
• Brad Edward Peterson, LISW-CP
• Susan Grizzard Peterson, N.P.
• Martha Deschamps Petoskey, PH.D.
• Alexa Petriella

• Family Medicine Physician in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; 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.