Jill A Petersen, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT21220 Issued in FL

Practice address

1807 Short Branch Dr
103
Trinity, FL 34655-4424

Phone

(727) 372-5500

Fax

(727) 372-8500

NPI assigned

Sep 20, 2006

Last updated

Jul 2, 2014By 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)

Enrolled

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.

• Physiotherapy Associates Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Estero, FL
  • NPI 1720039902
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1699872713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 SHORT BRANCH DR",
            "address_2": "#103",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346554424",
            "telephone_number": "727-372-5500",
            "fax_number": "727-372-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 SHORT BRANCH DR",
            "address_2": "103",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554424",
            "telephone_number": "727-372-5500",
            "fax_number": "727-372-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "JILL",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT21220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradford Alan Perez, MD
• Pergola Marketing Inc (Family Fitness Centers Physical Therapy)
• Shelley Nadira Persaud, MD
• Personal Pediatric Care PLLC
• Julie Peters, PA-C
• Phamhasell PA (The Pediatric Specialists Medical Group)
• An Phan
• Jillian Phillips
• Phoenix Regenerative Medicine Solutions, LLC
• Physical Medicine & Rehab Consultants LLC (RegenMed of Florida)

• Physical Therapist in Trinity, FL
• Providers in Trinity, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.