Blake Peterson, PT, DPT
NPI 1033780366ActiveIndividual· Physical Therapist· Raymore, MO
Physical Therapist (PT, DPT) with Rehab Specialists Inc, practicing in Raymore, Missouri. Enrolled in Medicare as practitioner - physical therapist in private practice and practitioner - physical therapist in private practice. Lists Mosaic Life Care at St Joseph as a hospital affiliation.
Overview
| NPI | 1033780366 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT, DPT |
| Sole proprietor | No |
| NPI issued | Jul 7, 2021 |
| Last updated in NPPES | Jul 7, 2021 |
| Certified by provider | Jul 7, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 2021026428 | MO |
| Physical Therapist | 225100000X | 11-06836 | KS |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (AZ); Practitioner - Physical Therapist in Private Practice (CA); Practitioner - Physical Therapist in Private Practice (MO) |
|---|
Education and affiliations
| Graduation year | 2021 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Rehab Specialists IncEncino, CA · 25 clinicians
Hospital affiliation
- Mosaic Life Care at St JosephSaint Joseph, MO
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