Emilie L Peterson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-3602 Issued in ID

Practice address

1800 Flandro Dr Ste 190
Pocatello, ID 83202-4940

Phone

(208) 233-2248

NPI assigned

Sep 6, 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

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family First Medical Center PLLCGroup PAC ID 1052480076, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21377/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/JIHBAA

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.

• Family First Medical Center, PLLC

  • Family Medicine Physician
  • Idaho Falls, ID
  • NPI 1033314273
  Medicare reassignment Care Compare group NPD
• McDonald Rehab, PC

  • Physical Therapist
  • Pocatello, ID
  • NPI 1497948509
  Medicare reassignment NPD
• Family First Medical Center

  • Geriatric Medicine (Family Medicine) Physician
  • Edinburg, TX
  • NPI 1326246901
  NPD (past)

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

{
    "created_epoch": "1409961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409961600000",
    "number": "1588065882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BIRDIE THOMPSON DR APT 801",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012774",
            "telephone_number": "208-570-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 FLANDRO DR STE 190",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832024940",
            "telephone_number": "208-233-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "EMILIE",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-06",
        "last_updated": "2014-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-3602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Peters
• James D Petersen, MD
• Barbara K Peterson, OCCUPT. THERAPIST
• Brittany Ann Peterson, OTR/L
• Cody Allen Peterson, M.D.
• Hannah Nicole Peterson, LMT
• Tamra J Peterson, LMSW, CADC
• Tandice Peterson
• Theodore William Peterson, O.T.R.
• Venita Jill Petti, OT/L

• Physical Therapist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2014; 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.