Mary E Peterson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1101341 Issued in KS

Practice address

11140 Thompson Ave
Lenexa, KS 66219-2301

Phone

(913) 789-4075

Fax

(913) 888-1728

NPI assigned

Mar 26, 2010

Last updated

Mar 26, 2010By 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 2

Addresses

Other names 1

• Miss Mary E Bennett Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1269561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269561600000",
    "number": "1730403213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11140 THOMPSON AVE",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662192301",
            "telephone_number": "913-789-4075",
            "fax_number": "913-888-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11140 THOMPSON AVE",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662192301",
            "telephone_number": "913-789-4075",
            "fax_number": "913-888-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-26",
        "last_updated": "2010-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "1101341",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "RO919",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BENNETT",
            "middle_name": "E",
            "prefix": "MISS",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Lenexa, KS
• Providers in Lenexa, KS by specialty
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2010; 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.