Active NPI
Jessica Lynn Peterson, D.C.
- Chiropractor
- Lawrence, KS
National Provider Identifier
1073531141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4930
- Practice address
- 901 Kentucky St Ste 102
Lawrence, KS 66044-2853 - Phone
- (785) 856-5353
- Fax
- (785) 856-7630
- NPI assigned
- Jul 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4930 | KS | Primary |
| Chiropractor | 111N00000X | 3329 | NC |
Addresses
Primary practice location
901 Kentucky St Ste 102
Lawrence, KS 66044-2853
Mailing address
901 Kentucky St Ste 102
Lawrence, KS 66044-2853
Phone (785) 856-5353
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 062152 | Other | KS | BC&BS |
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 |
|---|---|---|---|
| 3329 | NC | MD | Professional Counselor |
| 4930 | KS | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073531141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 KENTUCKY ST STE 102",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660442853",
"telephone_number": "785-856-5353",
"fax_number": "785-856-7320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 KENTUCKY ST STE 102",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660442853",
"telephone_number": "785-856-5353",
"fax_number": "785-856-7630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "JESSICA",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "KS",
"license": "4930",
"primary": true
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NC",
"license": "3329",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC&BS",
"identifier": "062152",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, KS
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.