Haley Tanya Peterson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11173 Issued in MN

Practice address

11995 Singletree LN Ste 120
Eden Prairie, MN 55344

Phone

(952) 373-5141

Fax

(763) 260-7653

NPI assigned

Sep 28, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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 and National Provider Directory roles.

• Perham Physical Therapy LTD.

  • Physical Therapist
  • Eden Prairie, MN
  • NPI 1437451853
  NPD
• Therapy Partners, Inc.

  • Multi-Specialty Clinic/Center
  • Saint Paul, MN
  • NPI 1407809494

  Physical Therapist

  NPD (past)
• Wagner Health LLC

  • Chiropractor
  • Plymouth, MN
  • NPI 1811694631
  NPD (past)

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1972088565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 120",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445338",
            "telephone_number": "952-373-5720",
            "fax_number": "763-260-7653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 120",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "55344",
            "telephone_number": "952-373-5141",
            "fax_number": "763-260-7653"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2460 Garlick Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993541786",
            "country_code": "US",
            "telephone_number": "509-375-1015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3335 Blaisdell Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554084429",
            "country_code": "US",
            "telephone_number": "952-222-5769",
            "fax_number": "763-260-7653",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7355 York Ave S",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554354701",
            "country_code": "US",
            "telephone_number": "952-222-5769",
            "fax_number": "763-260-7653",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3575 North Berens Rd NW",
            "address_purpose": "LOCATION",
            "city": "Prior Lake",
            "state": "MN",
            "postal_code": "553795899",
            "country_code": "US",
            "telephone_number": "952-222-5769",
            "fax_number": "763-260-7653",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12301 Ridgedale Dr",
            "address_purpose": "LOCATION",
            "city": "Minnetonka",
            "state": "MN",
            "postal_code": "553051738",
            "country_code": "US",
            "telephone_number": "952-222-5769",
            "fax_number": "763-260-7653",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7601 42nd Ave N",
            "address_purpose": "LOCATION",
            "city": "New Hope",
            "state": "MN",
            "postal_code": "554271226",
            "country_code": "US",
            "telephone_number": "952-222-5769",
            "fax_number": "763-260-7653",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1426 Mendota Rd",
            "address_purpose": "LOCATION",
            "city": "Inver Grove Heights",
            "state": "MN",
            "postal_code": "550771256",
            "country_code": "US",
            "telephone_number": "952-222-5769",
            "fax_number": "763-260-7653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "HALEY",
        "middle_name": "TANYA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-28",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "60885893",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony August Pesola, DDS
• Soodabeh Pessian
• Heidi Louise Peters, MD
• Sarah Mae Peters, DC
• Alexa Jones Peterson
• Holly Anne Peterson
• Jenna Vivian Peterson
• Madison Peterson
• Nathaniel L Peterson, DPT
• Taylor Peterson

• Physical Therapist in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; 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.