Kelly L. Peterson, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

103384 Issued in MN

Practice address

7250 France Ave S
Suite 305
Edina, MN 55435-4305

Phone

(952) 285-2840

NPI assigned

Jan 28, 2009

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.

• Capernaum Pediatric Therapy, Inc.

  • Home Health Agency
  • Edina, MN
  • NPI 1336393297
  NPD (past)
• Capernaum Pediatric Therapy, Inc.

  • Specialist
  • Richfield, MN
  • NPI 1619978228
  NPD (past)

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

{
    "created_epoch": "1233100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233100800000",
    "number": "1619115789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 BAKER RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553438684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7250 FRANCE AVE S",
            "address_2": "SUITE 305",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354305",
            "telephone_number": "952-285-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KELLY",
        "middle_name": "L.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-28",
        "last_updated": "2009-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MN",
            "license": "103384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erik Peterson, OTR/L
• Erin C Peterson, LMFT
• Joy Peterson, MSW, LGSW
• Kaitlin Rose Peterson, PA-C
• Kate S Peterson, ATC
• Krista Peterson, PSY.D.L.P.
• Matthew Christian Peterson, DPM
• Michelle C Peterson, MS LMFT
• Randolph K. Peterson, M.D.
• Robert K Peterson, DDS

• Pediatric Occupational Therapist in Edina, MN
• Providers in Edina, MN by specialty
• Pediatric Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; 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.