Anthony David Peterson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11685 Issued in MN

Practice address

619 6TH St W
Park Rapids, MN 56470-1301

Phone

(651) 528-2766

NPI assigned

Sep 21, 2020

Last updated

Sep 21, 2020By the provider in NPPES

Sex

Male

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 WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: apeterson546776@excellian.direct.allina.com

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.

• St. Croix Regional Medical Center

  • Critical Access Hospital
  • Saint Croix Falls, WI
  • NPI 1043240922

  Physical Therapist

  Medicare reassignment NPD
• St. Croix Regional Medical Center

  • Rural Health Clinic/Center
  • Balsam Lake, WI
  • NPI 1013423219
  NPD

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1700492162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9203 RASPBERRY CT NE",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566017853",
            "telephone_number": "651-528-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 6TH ST W",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564701301",
            "telephone_number": "651-528-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ANTHONY",
        "middle_name": "DAVID",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Rapids Family Dental PLLC
• Park Rapids Physical Therapy and Rehabilitation Center Inc
• Park Rapids Walker Eye Clinic OD PA
• Peabody Chiropractic
• Michael Perez, O.D.
• Jonathon R Peterson, PT
• Lisa Petrie
• Chasity Marie Phillips, PA-C
• Brady Pieper
• Daniel Wayne Pifher, PHARMD

• Physical Therapist in Park Rapids, MN
• Providers in Park Rapids, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.