KARISSA PETERSON – Physical Therapist, NPI 1104696384
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,109 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MN
Provider Addresses for KARISSA PETERSON
2700 E 28th St
Minneapolis, MN 554062990
Phone: (612) 345-7769
Type: Location
1200 CORPORATE DR STE 400
HOOVER, AL 352425424
Phone: (423) 497-0005
Type: Mailing
4356 MAYNARDVILLE HWY STE 3
MAYNARDVILLE, TN 378073646
Phone: (865) 630-9030
Type: Location
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: 2025-11-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240507004256 | I | Physical Therapist In Private Practice | TN | TBD |
| I20251106004636 | I | Physical Therapist In Private Practice | MN | TBD |
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.
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 55406)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| - | MN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| Physician Assistant | MN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| Family Practice | NY | |
| Registered Dietitian Or Nutrition Professional | MN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MN |
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