PETERSON PT LLC
NPI 1669480968
Pediatrics - Sports Medicine in Prescott, AZ

Q: What is Peterson Pt LLC's NPI number?

The NPI number for Peterson Pt LLC is 1669480968. It was assigned to this organization in the NPPES registry on August 3, 2006. The provider was formerly known as Peterson Physical Therapy.

Q: What is Peterson Pt LLC's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Sports Medicine, with taxonomy code 2080S0010X.

Q: When was this NPI record last updated?

The NPPES record for Peterson Pt LLC was last updated on May 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 03, 2006

1320 W IRON SPRINGS RD, PRESCOTT, AZ 86305(928) 771-2977(928) 771-2987 Get Directions Write a Review

NPPES record last updated: May 20, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Peterson Pt Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PETERSON PT LLC (NPI 1669480968), doing business as Peterson Physical Therapy, is a healthcare organization registered as a sports medicine in Prescott, Arizona and active in the NPI registry since August 2006. The organization lists Brek Lamont Peterson, Owner/physical Therapist, as its authorized official.

NPPES Registry Identity

NPI1669480968

Entity TypeOrganization

Primary Taxonomy2080S0010X

Legal Business NamePETERSON PT LLC

Location Address1320 W IRON SPRINGS RDPrescott, AZ 86305-1414

Mailing Address1320 W Iron Springs RdPrescott, AZ 86305-1414 · (928) 771-2977 · Fax (928) 771-2987

Phone(928) 771-2977

Fax(928) 771-2987

Organization SubpartNo

Authorized OfficialBrek Lamont PetersonOwner/physical Therapist · (928) 771-2977

Enumeration DateAugust 3, 2006

Last NPPES UpdateMay 20, 2024

NPPES CertifiedMay 20, 2024

✔ NPI 1669480968 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080S0010X

Licenses✔ Licensed in AZ · 5079✔ Licensed in AZ · 5810✔ Licensed in AZ · 6499

Definition

A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

1320 W IRON SPRINGS RD, Prescott, AZ 86305

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Other Names 1

Former Legal Business NamePeterson Physical Therapy

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Imperial Insurance Companies, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Peterson Pt Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 3 clinicians reassign Medicare billing to Peterson Pt LLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Christopher Legler, PT

Physical Therapist in Private Practice

NPI 1083842447

1320 W IRON SPRINGS RD
Prescott, AZ 86305

(928) 771-2977

✔ Accepts Medicare0.2 mi

Brek Peterson, P.T.

Physical Therapist in Private Practice

NPI 1518006444

1320 W IRON SPRINGS RD
Prescott, AZ 86305

(928) 771-2977

✔ Accepts Medicare0.2 mi

John Haws, PT, DPT

Physical Therapist in Private Practice

NPI 1225282726

3131 WESTERN AVE
Kingman, AZ 86401

(928) 718-0718

✔ Accepts Medicare99 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Peterson Pt LLC's NPI number?

The NPI number for Peterson Pt LLC is 1669480968. It was assigned to this organization in the NPPES registry on August 3, 2006. The provider was formerly known as Peterson Physical Therapy.

Where is Peterson Pt LLC located?

Peterson Pt LLC is located at 1320 W Iron Springs Rd, Prescott, AZ 86305. The listed phone number is (928) 771-2977.

What is Peterson Pt LLC's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Sports Medicine, with taxonomy code 2080S0010X.

Is Peterson Pt LLC enrolled in Medicare?

Yes. Peterson Pt LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Peterson Pt LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Physical Therapist in Private Practice, reassign their Medicare billing to Peterson Pt LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Peterson Pt LLC accept?

Health plans from Blue Cross Blue Shield of Arizona and Imperial Insurance Companies, Inc. list Peterson Pt LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Peterson Pt LLC was last updated on May 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.