Mikelle Marie Peterson, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7694 Issued in CO

Practice address

29670 County Road 372a
Buena Vista, CO 81211-9704

Phone

(303) 862-1840

NPI assigned

Dec 6, 2005

Last updated

Oct 1, 2018By 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

Enrolled in CO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Body Mechanics Physical Therapy LLCGroup PAC ID 9931324217, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Body Mechanics Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Buena Vista, CO
  • NPI 1407273857

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• MMP Inc

  dba Headwaters Home Therapy

  • Physical Therapist
  • Buena Vista, CO
  • NPI 1518442912
  NPD (past) Authorized official
• Atlas Physical Therapy at Stapleton, PLLC

  dba Atlas Physical Therapy West Denver

  • Physical Therapy Clinic/Center
  • Denver, CO
  • NPI 1124769179

  Physical Therapist

  NPD (past)
• Purpose Medical Professional Corporation

  dba Body In Balance Physical Therapy

  • Orthopedic Physical Therapist
  • Denver, CO
  • NPI 1164510038
  NPD (past)

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1861476574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29670 COUNTY ROAD 372A",
            "city": "BUENA VISTA",
            "state": "CO",
            "postal_code": "812119704",
            "telephone_number": "303-862-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29670 COUNTY ROAD 372A",
            "city": "BUENA VISTA",
            "state": "CO",
            "postal_code": "812119704",
            "telephone_number": "303-862-1840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3919 Tennyson St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802122113",
            "country_code": "US",
            "telephone_number": "303-477-5303",
            "fax_number": "303-477-5302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MIKELLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "7694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet D Ommen, MSN, FNP
• Craig Ronald Otteni, MD
• Patricia Winter PHD PC
• Mikaila Heldt Pence, MD
• Peter H Kuiper LCSW PC
• Abbey Lee Pikul, NP
• Poet's Glade
• Premier Home Care (Premier Outpatient Therapies)
• Premier Home Care Inc (Premier Therapies)
• Premier Home Care, Inc (Premier Therapies dba Premier Home Care Inc.)

• Physical Therapist in Buena Vista, CO
• Providers in Buena Vista, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; 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.