Individual provider Active NPI

Laura Lynn Peterson, D.C.

  • Chiropractor
  • Folsom, CA
National Provider Identifier
1043245350
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC26119 Issued in CA
Practice address
24988 Blue Ravine Rd
Suite 106
Folsom, CA 95630-5284
Phone
(916) 355-0440
Fax
(916) 355-0441
NPI assigned
Jul 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC26119 CA Primary

Addresses

Primary practice location

24988 Blue Ravine Rd
Suite 106
Folsom, CA 95630-5284

Mailing address

24988 Blue Ravine Rd
Suite 106
Folsom, CA 95630-5284
Phone (916) 355-0440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120209000516 CA Practitioner - Chiropractic 8820255417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

102 Herrill CT
Folsom, CA 95630-5509
Phone (916) 355-0440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC26119CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Laura Peterson Chiropractic, Inc. Chiropractor CurrentSince Mar 19, 1999 Accepting new patients

Locations

24988 Blue Ravine Rd
Ste 106
Folsom, CA 95630
Phone (916) 355-0440

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043245350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24988 BLUE RAVINE RD",
            "address_2": "SUITE 106",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956305284",
            "telephone_number": "916-355-0440",
            "fax_number": "916-355-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24988 BLUE RAVINE RD",
            "address_2": "SUITE 106",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956305284",
            "telephone_number": "916-355-0440",
            "fax_number": "916-355-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "LAURA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC26119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.