PETERSON PT LLC – NPI #1669480968
Pediatrics

A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

PETERSON PT LLC is a provider located in PRESCOTT, AZ. NPPES has assigned the NPI number 1669480968 to PETERSON PT LLC on August 03, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The former legal business name for this organization is PETERSON PHYSICAL THERAPY. The primary taxonomy selected by this provider is 2080S0010X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics, specializing in Sports Medicine

The NPI profile was previously updated about 2 years ago on May 20, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PETERSON PT LLC below.

NPI Profile for
PETERSON PT LLC

NPI Number
1669480968
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PETERSON PT LLC
Former Legal Business Name: PETERSON PHYSICAL THERAPY
Primary location
1320 W IRON SPRINGS RD
PRESCOTT, AZ 86305-1414
Phone: (928) 771-2977 Fax: (928) 771-2987
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
BREK PETERSON
OWNER/PHYSICAL THERAPIST
Phone: (928) 771-2977
Updated
Certification Date
May 20, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2080S0010X
- Pediatrics / Sports Medicine (Primary)
AZ 5079

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.