Individual provider Active NPI

Stewart Todd Peters, D.C.

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1093994816
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3772 Issued in NC
Practice address
11220 Golf Links Drive
Charlotte, NC 28277
Phone
(704) 901-7192
NPI assigned
Oct 29, 2007
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3772 NC Primary

Addresses

Primary practice location

11220 Golf Links Drive
Charlotte, NC 28277

Mailing address

PO Box 686
Chanhassen, MN 55317-0686
Phone (952) 229-7464

Other practice location 1

2721 X Ray Dr
Gastonia, NC 28054-7491
Phone (704) 853-5079

Other practice location 2

2721 X Ray Dr
Gastonia, NC 28054-7491
Phone (704) 853-5079

Other practice location 3

257 S Elliott Rd
Chapel Hill, NC 27514-5831
Phone (919) 942-1182

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Fitness Centers PC Chiropractor Past Accepting new patients

Organizations & group practices 2

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": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1093994816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 686",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553170686",
            "telephone_number": "952-229-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11220 GOLF LINKS DRIVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28277",
            "telephone_number": "704-901-7192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2721 X Ray Dr",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280547491",
            "country_code": "US",
            "telephone_number": "704-853-5079",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2721 X Ray Dr",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280547491",
            "country_code": "US",
            "telephone_number": "704-853-5079",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "257 S Elliott Rd",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275145831",
            "country_code": "US",
            "telephone_number": "919-942-1182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "STEWART",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.