KELLY ROSE PETERSON (NPI# 1013450907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013450907 |
| Entity Type | Individual |
| Full Name | KELLY ROSE PETERSON |
| Credential | DPT |
| Practice Address |
1190 Baker St Ste 105 Costa Mesa CA 92626-4105 |
| Practice Telephone | 7149793500 |
| Mailing Telephone | 7149793500 |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2016-11-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | PT292307 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326437120 | Kelly Leigh Peterson | Nurse Practitioner | 2200 Childrens Way Monroe Carell Jr, Doctor's Office Tower, 7th Floor, Suite 7100, Nashville, TN 37232-0001 | 2015-01-16 |
| 1336424027 | Kelly Rae Peterson | Nurse Anesthetist, Certified Registered | 9803 Vagabond Ln N, Maple Grove, MN 55311-1364 | 2011-10-13 |
| 1235413758 | Kelly Suzanne Peterson | Naturopath | 638 Fulton St W Suite B, Grand Rapids, MI 49504 | 2011-10-03 |
| 1710016563 | Kelly Peterson | Counselor | 5240 Ne Elam Young Pkwy Ste 100, Hillsboro, OR 97124 | 2007-03-05 |
| 1558399261 | Kelly B Peterson | Dentist | 5100 Grove St, Ste B, Marysville, WA 98270-4492 | 2006-06-29 |
| 1639787872 | Kelly Peterson | Military Health Care Provider | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-07-14 |
| 1255965208 | Kelly A Peterson | Nurse Practitioner | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-02-28 |
| 1639720014 | Kelly Ann Peterson | Counselor | 20288 Highway 15 N Ste 100, Hutchinson, MN 55350-5685 | 2019-09-26 |
| 1164087730 | Kelly Peterson | Registered Nurse | 410 W 10th Ave, Columbus, OH 43210-1240 | 2019-05-08 |
| 1366923963 | Kelly Peterson | Counselor | 205 Burlington Rd, Bedford, MA 01730-1406 | 2018-08-22 |
| Street Address |
1190 BAKER ST STE 105 |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92626-4105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536982 | Sergio Gutierrez | Behavior Technician | 3303 Harbor Blvd., Suite B8, Costa Mesa, CA 92626 | 2020-10-22 |
| 1780201848 | Kelly Chauvet | Behavior Technician | 1503 Nutmeg Place Suite 110, Costa Mesa, CA 92626 | 2020-07-06 |
| 1316564610 | Timo Rosa | Behavior Technician | 1503 Nutmeg Place, Suite 110, Costa Mesa, CA 92626 | 2020-07-02 |
| 1255966115 | Dalia A Sehweil | Behavior Technician | 1111 Baker, Costa Mesa, CA 92626 | 2020-03-11 |
| 1265071096 | Austin Stotelmyre | Behavior Technician | 1111 Baker St Costa Mesa 92626, Costa Mesa, CA 92626 | 2019-12-26 |
| 1396383022 | The Open Table | Community/Behavioral Health | 151 Kalmus Dr. Bldg C, Suite 100, Costa Mesa, CA 92626 | 2019-12-12 |
| 1851933550 | Jennifer Rivera | Behavior Technician | 1111 Baker St. Unit #a, Costa Mesa, CA 92626 | 2019-10-14 |
| 1962053595 | Peter Na | Behavior Technician | Behavior Functions 3303 Harbor Blvd, Ste B8, Costa Mesa, CA 92626 | 2019-09-25 |
| 1346897147 | Jennifer Lopez | Behavior Technician | 555 Alton Blvd Suite 150, Costa Mesa, CA 92626 | 2019-08-26 |
| 1679134084 | Danny Garcia Chiropractic, PC | Chiropractor | 1503 South Coast Drive, Suite 319, Costa Mesa, CA 92626 | 2019-06-26 |
| Find all providers in zip 92626 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467955146 | Drew James Keres | Physical Therapist | 409 Enclave Cir Apt 301, Costa Mesa, CA 92626 | 2018-03-09 |
| 1598284382 | Ryan Paulson | Physical Therapist | 2651 Irvine Ave Ste 128, Costa Mesa, CA 92627-4649 | 2017-09-13 |
| 1396278578 | Athletica Physical Therapy | Physical Therapist | 2112 Harbor Blvd, Costa Mesa, CA 92627-2530 | 2017-04-05 |
| 1457895633 | Michael Ito | Physical Therapist | 2863 Serang Pl, Costa Mesa, CA 92626-4826 | 2016-12-07 |
| 1306395488 | Lindsay Kirlin | Physical Therapist | 1555 Mesa Verde Dr E Apt 34a, Costa Mesa, CA 92626-5202 | 2016-09-29 |
| 1063873651 | Warren Buan | Physical Therapist | 1300 Adams Ave Apt 16l, Costa Mesa, CA 92626-8318 | 2016-03-10 |
| 1124486311 | Thomas Hoan Dinh | Physical Therapist | 2755 Bristol St Ste 130, Costa Mesa, CA 92626-5985 | 2016-02-03 |
| 1316302862 | Holly Copsey Gruber | Physical Therapist | 253 Hanover Dr, Costa Mesa, CA 92626-6173 | 2015-12-29 |
| 1225406572 | Moira Docherty | Physical Therapist | 129 W Wilson St Ste 202, Costa Mesa, CA 92627-1586 | 2015-09-03 |
| 1871984948 | Hiroki Yokoyama | Physical Therapist | 2777 Bristol St., Suite B, Prosport Physical Therapy, Costa Mesa, CA 92626 | 2015-02-11 |
| Find all providers in COSTA MESA | ||||
| City | COSTA MESA |
| Zip Code | 92626 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.