Active NPI
Reece Peterson
- Occupational Therapy Assistant
- New Richmond, WI
National Provider Identifier
1629448816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 202059
- Practice address
- 371 S Washington Ave
New Richmond, WI 54017-1511 - Phone
- (715) 220-3621
- NPI assigned
- Sep 30, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 202059 | MN | Primary |
Addresses
Primary practice location
371 S Washington Ave
New Richmond, WI 54017-1511
Mailing address
371 S Washington Ave
New Richmond, WI 54017-1511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202059 | MN | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443571200000",
"number": "1629448816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "371 S WASHINGTON AVE",
"city": "NEW RICHMOND",
"state": "WI",
"postal_code": "540171511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "371 S WASHINGTON AVE",
"city": "NEW RICHMOND",
"state": "WI",
"postal_code": "540171511",
"telephone_number": "715-220-3621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "REECE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-09-30",
"last_updated": "2015-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MN",
"license": "202059",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Richmond, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.