CASSIDY ELLYN PETERSON (NPI# 1760976245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760976245 |
| Entity Type | Individual |
| Full Name | CASSIDY ELLYN PETERSON |
| Credential | DPT |
| Practice Address |
155 Radio Dr Woodbury MN 55125-2619 |
| Mailing Address |
4879 Richard Ln Eagan MN 55122-2784 |
| Practice Telephone | 9528318742 |
| Mailing Telephone | 6512715700 |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2018-06-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4879 Richard Ln, Eagan, MN 551222784 | 6512715700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679837926 | Cassidy Marie Peterson | Registered Nurse | 2105 W 143rd St Ste 2, Burnsville, MN 55306-8000 | 2012-07-02 |
| Street Address |
155 RADIO DR |
| City | WOODBURY |
| State | MN |
| Zip Code | 55125-2619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710046883 | Martha Lee Wood | Physical Therapist | 155 Radio Dr, Woodbury, MN 55125-2619 | 2006-12-06 |
| 1609402213 | Julia Kristine Brown Ferrero | Occupational Therapist | 155 Radio Dr, Woodbury, MN 55125-2619 | 2020-03-14 |
| 1215572128 | Patrick Conlin Dewitt | Physician Assistant | 155 Radio Dr, Woodbury, MN 55125-2619 | 2019-11-14 |
| 1124687546 | Michael Charles Lofboom | Physical Therapist | 155 Radio Dr, Woodbury, MN 55125-2619 | 2019-06-10 |
| 1407341696 | Brian J Gahlon | Physical Therapist | 155 Radio Dr, Woodbury, MN 55125-2619 | 2018-06-29 |
| 1215421961 | Cameron Bentz | Physical Therapist | 155 Radio Dr, Woodbury, MN 55125-2619 | 2018-06-17 |
| 1396262416 | Megan Mccarthy | Physical Therapist | 155 Radio Dr, Woodbury, MN 55125-2619 | 2017-08-29 |
| 1790228369 | Collin Woll | Specialist/Technologist | 155 Radio Dr, Woodbury, MN 55125-2619 | 2016-11-29 |
| 1184179780 | Katelyn Marie Kubat Money | Physical Therapist | 155 Radio Dr, Woodbury, MN 55125 | 2016-08-24 |
| 1588036313 | Callie Zweber | Physical Therapist | 155 Radio Dr, Woodbury, MN 55125-2619 | 2015-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487268728 | Haley Kirkpatrick | Behavior Technician | 721 Commerce Dr., Woodbury, MN 55125 | 2020-09-03 |
| 1689218091 | Jordan Schmidt | Student in an Organized Health Care Education/Training Program | 1740 Welr Dr. #24, Woodbury, MN 55125 | 2019-10-30 |
| 1629619580 | Mackenzie Ann Funke | Occupational Therapist | 721 Commerce Drivve, Woodbury, MN 55125 | 2019-10-02 |
| 1700342029 | Darcy Stivland | Counselor | 1811 Weir Drive #270, Woodbury, MN 55125 | 2019-02-11 |
| 1235609884 | Elizabeth Kennedy Ward | Psychologist | 7582 Currell Blvd Suite 208, Woodbury, MN 55125 | 2018-11-27 |
| 1528573664 | Cory Lee Baumeister | Counselor | 652 Bielenberg Dr, Woodbury, MN 55125 | 2017-12-12 |
| 1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
| 1366988826 | Mark Your Home Health Care LLC | Home Health | 6053 Hudson Road, Suite 200, Woodbury, MN 55125 | 2017-01-09 |
| 1518415736 | Kubei Holdings Group LLC | Case Management | 6043 Hudson Rd Ste 340, Saint Paul, MN 55125 | 2016-09-16 |
| 1285087072 | Adrian Jung | Occupational Therapist | 155 Radio Drive, Woodbury, MN 55125 | 2016-07-18 |
| Find all providers in zip 55125 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518122456 | Elizabeth C Lostetter | Physical Therapist | 731 Bielenberg Dr Ste 107, Woodbury, MN 55125-1701 | 2008-07-21 |
| 1528237302 | James Michael Yares | Physical Therapist | 1625 Radio Dr Ste 220, Woodbury, MN 55125-9476 | 2008-02-26 |
| 1740404755 | Gina L Donato | Physical Therapist | 51 Sherman Hill Rd Ste A201, Woodbury, CT 06798-3694 | 2007-04-12 |
| 1073618773 | Jan Hanson | Physical Therapist | 1125 Woodbury Dr, Suite 100, Woodbury, MN 55129-9291 | 2006-09-14 |
| 1629004692 | Therex Rehab Specialists, LLC | Physical Therapist | 1125 Woodbury Drive, Suite 100, Woodbury, MN 55129 | 2006-06-23 |
| 1386689321 | Thomas Chen Lee | Physical Therapist | 170 Crossways Park Dr, Woodbury, NY 11797-2029 | 2006-06-16 |
| 1306899463 | Summit Orthopedics, Ltd | Physical Therapist | 710 Commerce Dr Ste 200, Woodbury, MN 55125 | 2006-05-18 |
| 1306806146 | Randy Lee Brehmer | Physical Therapist | 2090 Woodwinds Drive, Woodbury, MN 55125-2522 | 2006-03-24 |
| 1770552770 | Kristen Marie Holmen | Physical Therapist | 2090 Woodwinds Dr., Woodbury, MN 55125 | 2006-03-14 |
| 1407341696 | Brian J Gahlon | Physical Therapist | 155 Radio Dr, Woodbury, MN 55125-2619 | 2018-06-29 |
| Find all providers in WOODBURY | ||||
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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.