Brandi Peters, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1650-39 Issued in WI

Practice address

2717 18TH St
Suite 100
Kenosha, WI 53140-4666

Phone

(262) 551-5650

Fax

(866) 245-8064

NPI assigned

Jul 17, 2015

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

State licenses

Practice roles

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

• Physical Therapy and Rehab Specialists

  • Physical Therapist
  • Hinsdale, IL
  • NPI 1063666220
  NPD (past)

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437091200000",
    "number": "1548644776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3497",
            "city": "STURTEVANT",
            "state": "WI",
            "postal_code": "531770300",
            "telephone_number": "877-552-2996",
            "fax_number": "866-245-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 18TH ST",
            "address_2": "SUITE 100",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404666",
            "telephone_number": "262-551-5650",
            "fax_number": "866-245-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "BRANDI",
        "credential": "LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "1650-39",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ali Syed Pervez, DO
• Jawad Pervez
• Susanne Peschl, APNP
• Melissa Pestka
• Peter L. Emer, O.D.
• Jennie L Peters, PMHNP-BC, FNP
• Lori Peters, RN
• Bennet Petersen, MS, OTR/L
• Dawn Petersen, CSAC
• Jenny Petersen

• Athletic Trainer in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Athletic Trainer in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.