Karissa Peterson
NPI 1104696384ActiveIndividual· Physical Therapist· Maynardville, TN
Physical Therapist in Maynardville, Tennessee, trained at University of North Dakota School of Medicine (class of 2023). Medicare paid $21,256 for services to 53 patients in 2024.
Overview
| NPI | 1104696384 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Jan 8, 2024 |
| Last updated in NPPES | Dec 17, 2024 |
| Certified by provider | Dec 17, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 15542 | TN |
| Physical Therapist, Orthopedic | 2251X0800X | 13293 | MN |
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 Practitioner - Physical Therapist in Private Practice (MN); Practitioner - Physical Therapist in Private Practice (TN) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 53 |
|---|---|
| Services billed | 1,125 across 12 procedure codes |
| Paid by Medicare | $21,256 |
Education and affiliations
| Medical school | University of North Dakota School of Medicine |
|---|---|
| Graduation year | 2023 |
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Premier OBGYN of Minnesota PLLCBurnsville, MN · 89 clinicians
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