Zachary Leland Peterson, DC
Individual provider Active NPI Chiropractor · Spicer, MN
NPI 1083236384 · NPPES record last updated May 11, 2020
Key facts
- NPI
- 1083236384
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 6731 (MN)
- Practice address
- 194 Progress Way
Spicer, MN 56288-5000 - Phone
- (320) 583-5839
- NPI assigned
- May 11, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- National College of Chiropractic, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Peterson Wellness Clinic P.a.
Practice addresses (Care Compare)
120 W S St
Spicer, MN 56288-4600
Phone (320) 409-1441
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200527000233 | MN | Practitioner - Chiropractic | 8022439272 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ametrine Mental Health PLLC | Current |
Accepting new patients | |
| Peterson Wellness Clinic P.a. | Chiropractor | Current |
Accepting new patients |
Locations
120 W South St
Spicer, MN 56288
Phone (320) 409-1441
194 Progress Way
Spicer, MN 56288
Phone (320) 583-5839
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6731 | MN | Yes |
Addresses
Primary practice location
194 Progress Way
Spicer, MN 56288-5000
Mailing address
194 Progress Way
Spicer, MN 56288-5000
Phone (320) 583-5839
Other providers in Spicer, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.