Luke Charles Peterson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT019817 Issued in OH

Practice address

1265 Boardman Canfield Rd
Boardman, OH 44512-4010

Phone

(330) 758-9400

Fax

(330) 726-8676

NPI assigned

May 11, 2022

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 OH

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ohio Sports and Spine Institute LTDGroup PAC ID 6800792938, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ohio Sports & Spine Institute, LTD

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Boardman, OH
  • NPI 1962455196
  Medicare reassignment Care Compare group NPD
• Ohio Sports & Spine Institute, LTD

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • East Liverpool, OH
  • NPI 1760148357
  NPD

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1831835958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124010",
            "telephone_number": "330-758-9400",
            "fax_number": "330-726-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124010",
            "telephone_number": "330-758-9400",
            "fax_number": "330-726-8676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8720 E Market St Ste 10",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444842364",
            "country_code": "US",
            "telephone_number": "330-469-2519",
            "fax_number": "330-726-8676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16844 Saint Clair Ave",
            "address_purpose": "LOCATION",
            "city": "East Liverpool",
            "state": "OH",
            "postal_code": "439204277",
            "country_code": "US",
            "telephone_number": "330-386-6500",
            "fax_number": "330-386-1277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "LUKE",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT019817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra E Perrotta, MSED, LPCC
• Wardah Pervez
• Laura Marie Pesci, D.O.
• Morgan Pesnell
• Carl Roy Peterson III, M.D., M.S.
• Mario Petrino
• Peter J Petroff
• Jennifer Rebecca Petruska, NNP
• Vincent J Peyko Jr.
• Jasmine R Phillips, CDCA, OCPSA, QMHS

• Physical Therapist in Boardman, OH
• Providers in Boardman, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.