Jessica Lynn Peterson, ND, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

84000210A Issued in IN

Practice address

1139 Joliet St
Dyer, IN 46311-1926

Phone

(219) 641-7359

NPI assigned

Jun 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Continuim Wellness, LLC.

  • Medical Specialty Clinic/Center
  • Dyer, IN
  • NPI 1578170486

  Multi-Specialty

  NPD
• Alternative Healing Works LLC

  • Acupuncturist
  • Dyer, IN
  • NPI 1710203039
  NPD (past)

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1093331126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10653 MILLARD DR",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463739150",
            "telephone_number": "708-712-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 JOLIET ST",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111926",
            "telephone_number": "219-641-7359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "ND, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": "VT",
            "license": "099.0134092",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IN",
            "license": "84000210A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul a Veld OD PLLC (Veld Vision Center)
• Lisa M Pazdur, NURSE PRACTITIONER
• Pediatric Dental Care, Inc.
• Maritta A Penegor, NP-BC
• Linsey Perez
• Physical Therapy/E.T.C.
• Pick N Drop LLC
• Michael Alan Polich, N.P.
• Amber Poortenga
• Premier Adult Day Service

• Acupuncturist in Dyer, IN
• Providers in Dyer, IN by specialty
• Acupuncturist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.