Christy Sue Peterson, PT
Individual provider Active NPI Physical Therapist · Ord, NE
NPI 1578840484 · NPPES record last updated Nov 5, 2011
Key facts
- NPI
- 1578840484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 670 (NE)
- Practice address
- 47581 815TH Rd
Ord, NE 68862-5362 - Phone
- (308) 730-1331
- Fax
- (308) 728-5644
- NPI assigned
- Nov 5, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 670 | NE | MD | Obstetrics & Gynecology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 670 | NE | Yes |
Addresses
Primary practice location
47581 815TH Rd
Ord, NE 68862-5362
Mailing address
47581 815TH Rd
Ord, NE 68862-5362
Phone (308) 730-1331
Other providers in Ord, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.