Jordan Matthew Peterson, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH60990272 Issued in WA

Practice address

103 N 1St St
Elma, WA 98541-9854

Phone

(360) 482-5155

NPI assigned

Oct 7, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Cleveland Chiropractic College - Kansas City, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Core Chiropractic Clinic, P.S.

  • Chiropractor
  • Montesano, WA
  • NPI 1942696638
  Medicare reassignment NPD
• M & K Etc Inc

  dba Elma Chiroptactic Clinic

  • Chiropractor
  • Elma, WA
  • NPI 1699817197
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1003457466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 656",
            "city": "ELMA",
            "state": "WA",
            "postal_code": "985410656",
            "telephone_number": "360-482-5155",
            "fax_number": "360-482-4155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N 1ST ST",
            "city": "ELMA",
            "state": "WA",
            "postal_code": "985419854",
            "telephone_number": "360-482-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JORDAN",
        "middle_name": "MATTHEW",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-07",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60990272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claude Ouellette, LMHC
• Pacific Medical Specialty Group
• Holly Hope Paul, ARNP
• Paulines Peaceful Pathways PLLC
• Kimberly Ann Peters, CDP
• Kerry G Peterson, ARNP, FNP-C
• Matthew S. Peterson, D.C.
• Michelle Elizabeth Peterson
• Sarah Joy Pinkerton, ARNP
• Brock Dustin Pohl, CDP

• Chiropractor in Elma, WA
• Providers in Elma, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.