Kaitlin Rose Petrie

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0004215 Issued in CO

Practice address

4547 Palisades Park VW
Colorado Springs, CO 80906-8697

Phone

(800) 967-4667

NPI assigned

Feb 24, 2015

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 CO

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1659763944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4547 PALISADES PARK VW",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809068697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4547 PALISADES PARK VW",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809068697",
            "telephone_number": "800-967-4667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1221 Durston Rd",
            "address_purpose": "LOCATION",
            "city": "Bozeman",
            "state": "MT",
            "postal_code": "597152725",
            "country_code": "US",
            "telephone_number": "888-873-4221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRIE",
        "first_name": "KAITLIN",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-24",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "0004215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyffanie Peterson
• Maureen Petik
• Anja Petkash, RN
• Ciara Rayne Petrash
• Jeana M Petricko, PT
• Matthew Petrie, M.D.
• Jessica Susan Petrone, LPC
• Lara Petropoulos
• Suzana Milorada Petrovic-Sweney, PTA
• Tamara Ann Petrowsky Gorman, MS, CCC-SLP

• Occupational Therapist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Occupational Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.