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

Kelsey Peterson

Individual provider Occupational Therapist · NPI 1730604802

Kelsey Peterson is an Occupational Therapist in Private Practice in Bridgeport, Michigan. Graduated from Saginaw Valley Medical College - Nlg in 2022, 4 years ago. Practices with Renue 004 Bridgeport LLC, an 11-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
4
Trained at
Saginaw Valley Medical College - Nlg
Licensed in
MI
In the registry since
2017
Specialties on file
2

Practice location Address checks out

5460 W Rolling Hills Dr
Bridgeport, MI 48722-9668
Phone: (989) 272-4500
Fax: (989) 272-4501
Show map & directions

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

Additional practice locations (1)

  • 804 N Water St, Bay City, MI 48708-5620 — (989) 450-3341

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 5201013406 (MI)
Behavior Technician Taxonomy 106S00000X

Record details

NPI number1730604802
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 9, 2017
Last updated in NPPESDecember 8, 2025
Certification dateDecember 8, 2025
Mailing address41521 W 11 Mile Rd, Novi, MI 48375-1803

Medicare enrollment

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

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolSAGINAW VALLEY MEDICAL COLLEGE - NLG
Graduated 2022 (4 years in practice)
Group practice Renue 004 Bridgeport Llc — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Bridgeport