Megan Petersen, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0603 Issued in SD

Practice address

600 W Community Dr
Flandreau, SD 57028-1060

Phone

(605) 997-3263

NPI assigned

Oct 26, 2023

Last updated

Oct 26, 2023By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Flandreau School District #50-3

  • Local Education Agency (LEA)
  • Flandreau, SD
  • NPI 1407993165
  NPD (past)

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

{
    "created_epoch": "1698278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1669244273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1754 110TH AVE",
            "city": "LUVERNE",
            "state": "MN",
            "postal_code": "561564011",
            "telephone_number": "507-329-3818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W COMMUNITY DR",
            "city": "FLANDREAU",
            "state": "SD",
            "postal_code": "570281060",
            "telephone_number": "605-997-3263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "MEGAN",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-26",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SD",
            "license": "0603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abbey Jo Kitto, CNP-FNP
• Katherine E Krystosek, MS, ATC
• Leslie J. Heinemann, DDS, PC
• Amanda McMillan, CNP
• Jeanie Alyson Nold, R.PH.
• Jeffery Lee Peterson, M.D.
• Mariah Peterson, CNP
• Scott Peterson, MD
• James Edson Powell, M.D.
• Prairie Phoenix PLLC

• Athletic Trainer in Flandreau, SD
• Providers in Flandreau, SD by specialty
• Athletic Trainer in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.