Active NPI
Terry K Peterson, CH
- Chiropractor
- Mesa, AZ
National Provider Identifier
1003921800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2065
- Practice address
- 6750 E Broadway Rd
Mesa, AZ 85206-1700 - Phone
- (480) 396-2484
- Fax
- (480) 830-2790
- NPI assigned
- Aug 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2065 | AZ | Primary |
Addresses
Primary practice location
6750 E Broadway Rd
Mesa, AZ 85206-1700
Mailing address
6750 E Broadway Rd
Mesa, AZ 85206-1700
Phone (480) 396-2484
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2065 | AZ | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208908800000",
"number": "1003921800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6750 E BROADWAY RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852061700",
"telephone_number": "480-396-2484",
"fax_number": "480-830-2790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6750 E BROADWAY RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852061700",
"telephone_number": "480-396-2484",
"fax_number": "480-830-2790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "TERRY",
"middle_name": "K",
"credential": "CH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-20",
"last_updated": "2008-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AZ",
"license": "2065",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.