Peterson PT LLC
NPI 1669480968 · Pediatric Sports Medicine Physician · Prescott, AZ
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Peterson PT LLC is a Pediatric Sports Medicine Physician organization in Prescott, AZ (NPI 1669480968).
Provider details
- NPI number
- 1669480968
- Entity type
- Organization
- Primary specialty
- Pediatric Sports Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Brek Peterson, Owner/Physical Therapist(928) 771-2977
- License
- 5810 (AZ)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Former legal business name
- Peterson Physical Therapy
Registry dates
- Enumerated
- 2006-08-03
- Last updated
- 2024-05-20
- Certified
- 2024-05-20
Frequently asked questions
- What is Peterson PT LLC's NPI number?
- Peterson PT LLC's National Provider Identifier (NPI) is 1669480968, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Peterson PT LLC?
- Peterson PT LLC is classified in the NPPES registry as Pediatric Sports Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Peterson PT LLC located?
- Peterson PT LLC's practice location on file with NPPES is 1320 W Iron Springs Rd, Prescott, AZ 86305-1414.
- What is Peterson PT LLC's phone number?
- The practice phone number listed in the NPPES registry for Peterson PT LLC is (928) 771-2977.
- Does Peterson PT LLC accept Medicare?
- Peterson PT LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Peterson PT LLC?
- The authorized official listed on Peterson PT LLC's NPPES record is Brek Peterson, Owner/Physical Therapist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Peterson PT LLC's NPI active?
- Yes — Peterson PT LLC's NPI (1669480968) is active in the NPPES registry as of the last update on 2024-05-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.