Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Karissa Peterson

Individual provider Orthopedic Physical Therapist · NPI 1104696384

Karissa Peterson is a Physical Therapist in Private Practice in Maynardville, Tennessee. Graduated from University of North Dakota School of Medicine in 2023, 3 years ago. Practices with Premier OBGYN of Minnesota PLLC, a 89-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota and Tennessee.

Years since qualifying
3
Trained at
University of North Dakota School of Medicine
Licensed in
MN, TN
In the registry since
2024
Specialties on file
2

Practice location Address checks out

4356 Maynardville Hwy Ste 3
Maynardville, TN 37807-3646
Phone: (865) 630-9030
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2700 E 28th St, Minneapolis, MN 55406-2990 — (612) 345-7769

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 15542 (TN)
Orthopedic Physical Therapist Taxonomy 2251X0800X · Licence 13293 (MN)

Record details

NPI number1104696384
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 8, 2024
Last updated in NPPESDecember 17, 2024
Certification dateDecember 17, 2024
Mailing address1200 Corporate Dr Ste 400, Hoover, AL 35242-5424

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolUNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE
Graduated 2023 (3 years in practice)
Group practice Premier Obgyn Of Minnesota Pllc — 89 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount