NPIMap

Organization Active NPI

Children'S Physical Therapy LLC

  • Pediatric Physical Therapist
  • Prairie Village, KS
National Provider Identifier
1992731699
Registry record updated Apr 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
1100490 Issued in KS
Legal business name
CHILDREN'S PHYSICAL THERAPY LLC
Practice address
5250 W 94TH Ter
Suite 200
Prairie Village, KS 66207-2502
Phone
(913) 345-1997
Fax
(913) 345-1990
NPI assigned
Jun 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2014

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

Authorized official

Name
Mrs. Teresa M Petersen, PT, MS, PCS
Title
Owner
Phone
(913) 345-9310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251P0200X 1100490 KS Primary

Addresses

Primary practice location

5250 W 94TH Ter
Suite 200
Prairie Village, KS 66207-2502

Mailing address

5250 W 94TH Ter
Suite 200
Prairie Village, KS 66207-2502
Phone (913) 345-1997

Other identifiers 2

IdentifierTypeStateIssuer
200355530AMedicaidKS
507615102MedicaidMO

National Provider Directory

National Provider Directory
Tax ID family
Children'S Physical Therapy Associates5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5250 W 94th Ter
Ste 200
Prairie Village, KS 66207
Phone (913) 345-1997

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397174400000",
    "number": "1992731699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 W 94TH TER",
            "address_2": "SUITE 200",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662072502",
            "telephone_number": "913-345-1997",
            "fax_number": "913-345-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 W 94TH TER",
            "address_2": "SUITE 200",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662072502",
            "telephone_number": "913-345-1997",
            "fax_number": "913-345-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2014-04-11",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-345-9310",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT, MS, PCS"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "KS",
            "license": "1100490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200355530A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507615102",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairie Village, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2014; 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.