Katherine Jane Petersen, OTR/L

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

314735 Issued in OR

Practice address

780 NW Garden Valley Blvd Ste 310
Roseburg, OR 97471-2298

Phone

(541) 640-7625

NPI assigned

Apr 26, 2016

Last updated

Jan 24, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 OR

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Icco, LLC

  dba BestMed

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1407004757
  Medicare reassignment NPD
• Icco LLC

  dba BestMed

  • Rural Health Clinic/Center
  • Florence, OR
  • NPI 1740896547
  NPD
• Icco, LLC

  dba Thurston Urgent Care

  • Urgent Care Clinic/Center
  • Springfield, OR
  • NPI 1528356953
  NPD
• Explore Engage Enjoy

  • Pediatric Occupational Therapist
  • Roseburg, OR
  • NPI 1073212924
  NPD (past)

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1861847972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1292 HIGH ST STE 224",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013238",
            "telephone_number": "541-500-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 NW GARDEN VALLEY BLVD STE 310",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712298",
            "telephone_number": "541-640-7625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1740 NW Goetz St",
            "address_purpose": "LOCATION",
            "city": "Roseburg",
            "state": "OR",
            "postal_code": "974711613",
            "country_code": "US",
            "telephone_number": "541-640-7625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "KATHERINE",
        "middle_name": "JANE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-26",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "OR",
            "license": "314735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Petchell
• India Chaney Peter, DO
• Kristine Elizabeth Peterman
• Kathleen Peters, MSW
• Jonathan Michael Brown Petersen, D.M.D.
• Morgan Michelle Petersen, FNP
• Ryan Jon Petersen, M.D.
• Michael Peterson, PA-C
• Luana Ionela Petre Nedita, MD
• Sorin Petre, M.D.

• Hand Occupational Therapist in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Hand Occupational Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.