KELLY RENEE PETERSON (OTR/L) – Occupational Therapist, NPI 1467682070

KELLY RENEE PETERSON (OTR/L) is a healthcare provider. based in Chariton, Iowa. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials OTR/L. They hold a License No. 01298 (IA). The NPI Number for KELLY RENEE PETERSON (OTR/L) is 1467682070

Main info

Female
27 Years Of Experience
Accepts Medicare Assignment
Name
KELLY RENEE PETERSON (OTR/L)
NPI
1467682070
Phone
(641) 774-3000
Address
1200 N 7TH ST
Enumeration Date
16 July 2009
Last Update Date
16 July 2009

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3196689453
Graduation Year
1999 (27 years ago)
PAC ID
8123458288
Group Practice PAC ID
4789621723
Professional Enrollment ID
I20200414001464
Address ID
IA523619429WI507XXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:16State licenses:1Digital endpointsOther names

252 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in IA

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Provider Addresses for KELLY RENEE PETERSON (OTR/L)

  • Lucas County Health Center, 1200, North 7th Street, Chariton, Lucas County, Iowa, 50049, United States

    CHARITON, IA 500491210

    Phone: (641) 774-3000

    Fax: (641) 774-3207

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-04-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200414001464IOccupational Therapist In Private PracticeIATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 50049)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789621723View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeIA
Physical Therapist In Private PracticeIA
Physical Therapist In Private PracticeIA
Physical Therapist In Private PracticeIA
Physical Therapist In Private PracticeIA
Physical Therapist In Private PracticeIA
-IA
Physical Therapist In Private PracticeIA
Physical Therapist In Private PracticeIA
Physical Therapist In Private PracticeIA

Reviews

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Frequently asked questions

Is KELLY RENEE PETERSON (OTR/L) listed with a National Provider Identifier?
Yes — KELLY RENEE PETERSON (OTR/L) has NPI 1467682070 on file in the registry.
Is KELLY RENEE PETERSON (OTR/L) still an active registrant?
KELLY RENEE PETERSON (OTR/L) carries an active NPI according to the public dataset.
What expertise is attributed to KELLY RENEE PETERSON (OTR/L)?
KELLY RENEE PETERSON (OTR/L)'s specialty line reads Occupational Therapist. Clinical services aligned with this taxonomy classification.
Where in Iowa is KELLY RENEE PETERSON (OTR/L) registered?
Use Chariton, Iowa as the headline location for KELLY RENEE PETERSON (OTR/L) here.
Can I trust this NPI listing for KELLY RENEE PETERSON (OTR/L)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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