CP Physical Therapy PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

2589 Issued in NE

Legal business name

CP PHYSICAL THERAPY PC

Practice address

1439 E 23Rd St
Fremont, NE 68025-2433

Phone

(402) 669-8067

NPI assigned

May 17, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Chris Lawrence Petersen IV, PT,DPTNPI 1407047822

Title

Physical Therapist/Owner

Phone

(402) 669-8067

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chris L Petersen, D.P.T.

  • Physical Therapist
  • Fremont, NE
  • NPI 1407047822
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463443200000",
    "number": "1598112724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1439 E 23RD ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1439 E 23RD ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252433",
            "telephone_number": "402-669-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CP PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-17",
        "last_updated": "2016-05-17",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "402-669-8067",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "PT,DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NE",
            "license": "2589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kasaira Y Consbruck
• Carter Noal Cook, MD
• Sarah Dawn Cooper, MS, CCC-SLP
• Nancy Costello
• Carrie Coufal
• Garrett A Craig, DPT
• Michelle L Craig, OTD, OTR/L
• Jay C Cramer, MS LMHP
• Sarah W Cross
• Gina Rochelle Crosslin, R.T.(T)

• Physical Therapy Clinic/Center in Fremont, NE
• Providers in Fremont, NE by specialty
• Physical Therapy Clinic/Center in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.