Kristina Anna Glad Peterson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 33079 Issued in CA

Practice address

6177 River Crest Dr Ste a
Riverside, CA 92507-0728

Phone

(951) 653-4480

Fax

(951) 653-5051

NPI assigned

Oct 4, 2006

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 identifiers 1

Other names 1

• Miss Kristina Anna Glald Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Coast Spine Restoration Center IncGroup PAC ID 7214824648, 19 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.

• West Coast Spine Restoration Center, Inc

  • Physical Therapist
  • Riverside, CA
  • NPI 1992887616
  Medicare reassignment Care Compare group NPD
• Napa Valley Physical Therapy Center Inc

  • Physical Therapy Clinic/Center
  • Napa, CA
  • NPI 1598869869

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218758400000",
    "number": "1942396668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 SYCAMORE CANYON BLVD APT 116",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925078467",
            "telephone_number": "951-686-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6177 RIVER CREST DR STE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070728",
            "telephone_number": "951-653-4480",
            "fax_number": "951-653-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KRISTINA",
        "middle_name": "ANNA GLAD",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 33079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PT33079",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "GLALD",
            "middle_name": "ANNA",
            "prefix": "MISS",
            "credential": "D.P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vicki Suzanne Peterson-Redding
• Amber Peterson
• Glenn A Peterson, CADC-I
• Jamie-Lynn Peterson
• Kimberly Peterson
• Mary Kathryn Peterson, MPT
• Robert G. Peterson, DDS
• Thomas James Peterson, LCSW
• Tyrone Peterson
• Zachary James Peterson

• Physical Therapist in Riverside, CA
• Providers in Riverside, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; 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.