Jennifer Kay Peterson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5150 Issued in MN

Practice address

11671 Fountains Dr
Suite 220
Maple Grove, MN 55369-4711

Phone

(763) 420-2767

NPI assigned

Oct 6, 2006

Last updated

Mar 17, 2015By 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

Other names 1

• Jennifer Kay Giroux Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Fox Rehabilitation Services MN LLC

  • Physical Therapist
  • Minnetonka, MN
  • NPI 1356802862
  NPD
• Advanced Arm Dynamics of Minnesota

  • Prosthetic/Orthotic Supplier
  • Maple Grove, MN
  • NPI 1346533577
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1871680454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11671 FOUNTAINS DR",
            "address_2": "SUITE 220",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694711",
            "telephone_number": "763-420-2767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11671 FOUNTAINS DR",
            "address_2": "SUITE 220",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694711",
            "telephone_number": "763-420-2767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JENNIFER",
        "middle_name": "KAY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "5150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GIROUX",
            "middle_name": "KAY",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Jean Petersen, PHARM.D.
• Peterson Counseling and Consulting LLC
• Beth K. Peterson, MSW, LICSW
• Colleen Ann Peterson, RN
• Emily Jane Peterson, FNP
• Katie Peterson
• Kelly Rae Peterson, CRNA
• Jennifer Petricig
• Heidi Petzel, DDS
• Jenna Pfeil

• Physical Therapist in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; 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.