Kelly Petersen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT031598 Issued in PA

Practice address

100 Wheatfield Dr Ste 1
Milford, PA 18337-7699

Phone

(570) 296-5911

NPI assigned

Jul 7, 2023

Last updated

Aug 4, 2023By the provider in NPPES

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

Enrolled in PA, WI2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DPT Holdings LLCGroup PAC ID 4688679293, 170 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• DPT Holdings, LLC

  dba Doctors of Physical Therapy

  • Physical Therapist
  • Plainfield, IL
  • NPI 1689648602

  WI

  Medicare reassignment Care Compare group NPD
• Drayer Physical Therapy Institute LLC

  • Physical Therapist
  • Hummelstown, PA
  • NPI 1538122700
  Medicare reassignment NPD
• Drayer Physical Therapy Institute LLC

  • Physical Therapist
  • York, PA
  • NPI 1053348409
  NPD
• Drayer Physical Therapy Institute LLC

  • Physical Therapist
  • York, PA
  • NPI 1700421716
  NPD

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1538847801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-405-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WHEATFIELD DR STE 1",
            "city": "MILFORD",
            "state": "PA",
            "postal_code": "183377699",
            "telephone_number": "570-296-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "KELLY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT031598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Practices of Northeastern PA
• Peerless Medical Inc (Drug 123)
• Marilyn Pena
• Kelly Ann Peters
• Danielle Petersen, COTA
• Donnamarie Piazza, LCSW
• Stephanie Pieros, M.S., CCC-SLP
• Pike County Advanced Life Support Inc
• Jose L Pino-Y-Torres, M.D.
• Pocono Medical Care Inc.

• Physical Therapist in Milford, PA
• Providers in Milford, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.