Peterson Sports Therapy LLC
NPI 1104410216ActiveOrganization· Physical Therapist· Danvers, MA
Physical Therapist in Danvers, Massachusetts, registered in NPPES in March 2021. The authorized official on file is Stacy M. Peterson, D.O., Owner/Practice Manager. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1104410216 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 1, 2021 |
| Last updated in NPPES | Mar 1, 2021 |
| Certified by provider | Mar 1, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (MA) |
|---|
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