Active NPI
Jeannie Sue Peterson
- Physical Therapist
- Nunn, CO
National Provider Identifier
1902440183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0015305
- Practice address
- 51320 County Road 33
Nunn, CO 80648-9734 - Phone
- (923) 285-2293
- NPI assigned
- Oct 31, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 0015305 | CO | Primary |
Addresses
Primary practice location
51320 County Road 33
Nunn, CO 80648-9734
Mailing address
51320 County Road 33
Nunn, CO 80648-9734
Phone (925) 285-2293
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jeannie.peterson@genesishcc.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0015305 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572480000000",
"number": "1902440183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51320 COUNTY ROAD 33",
"city": "NUNN",
"state": "CO",
"postal_code": "806489734",
"telephone_number": "925-285-2293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51320 COUNTY ROAD 33",
"city": "NUNN",
"state": "CO",
"postal_code": "806489734",
"telephone_number": "923-285-2293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "JEANNIE",
"middle_name": "SUE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-31",
"last_updated": "2019-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "0015305",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jeannie.peterson@genesishcc.com",
"affiliation": "N",
"endpointDescription": "Genesis email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "51320 County Road 33",
"city": "Nunn",
"state": "CO",
"country_code": "US",
"postal_code": "806489734",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Nunn, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.