Kimberlee A Peterson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1528

Practice address

172 W Main St
Kuna, ID 83634

Phone

(208) 922-9828

Fax

(208) 922-3499

NPI assigned

Sep 1, 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

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain Land Rehabilitation LLCGroup PAC ID 9234048745, 207 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Mountain Land Rehabilitation LLC

  • Physical Therapist
  • Salt Lake City, UT
  • NPI 1265549372

  ID

  Medicare reassignment Care Compare group NPD
• McDonald Rehab, PC

  dba Superior Physical Therapy

  • Physical Therapist
  • Pocatello, ID
  • NPI 1497948509
  NPD (past)
• Registered Physical Therapists LLC

  • Physical Therapist
  • Sandy, UT
  • NPI 1477582633
  NPD (past)

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992807036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 711185",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84171",
            "telephone_number": "801-942-3311",
            "fax_number": "801-942-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 W MAIN ST",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "83634",
            "telephone_number": "208-922-9828",
            "fax_number": "208-922-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KIMBERLEE",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": "PT1528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0027023000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mychaela Marie Parker
• Justin Loren Parkinson, DO
• Jocelyn Dee Patchett, PMHNP-BC
• Paul E Blaisdell DDS PLLC (Swan Falls Family Dentistry)
• Taylor Marie Pearl, DDS
• Alexis Pettersen, PT, DPT
• Phalanx Wellness LLC (Phalanx Wellness)
• Jana Adrienne Pintor, PHARM D
• Pioneer Sports & Pain Center LLC
• Darrel Robert Porr, MD

• Physical Therapist in Kuna, ID
• Providers in Kuna, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.