Peterson Chiropractic Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1372 Issued in NE

Legal business name

PETERSON CHIROPRACTIC INC

Doing business as

SouthPointe Chiropractic

Practice address

3200 Pine Lake Rd
Suite B
Lincoln, NE 68516-6035

Phone

(402) 423-5050

Fax

(402) 423-5065

NPI assigned

May 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jeremy Ryan Peterson, D.C.NPI 1285713248

Title

Owner

Phone

(402) 423-5050

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SouthPointe Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeremy R Peterson, DC

  • Chiropractor
  • Lincoln, NE
  • NPI 1285713248
  Medicare reassignment NPD Authorized official
• Jake Allan Akerson, D.C.

  • Chiropractor
  • Lincoln, NE
  • NPI 1497949739
  NPD (past)
• Jeffrey Wayne Freeman, DC

  • Chiropractor
  • Lincoln, NE
  • NPI 1578645479
  NPD (past)
• Rick Alan Rohrs, DC

  • Chiropractor
  • Lincoln, NE
  • NPI 1013998103
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114136140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 PINE LAKE RD",
            "address_2": "SUITE B",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685166035",
            "telephone_number": "402-423-5050",
            "fax_number": "402-423-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 PINE LAKE RD",
            "address_2": "SUITE B",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685166035",
            "telephone_number": "402-423-5050",
            "fax_number": "402-423-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-423-5050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025223200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SouthPointe Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle A Petersen, PA-C
• Michelle B Petersen, M.D.
• Paul F Petersen, MD
• Sharee Petersen
• Sydney Rae Petersen, PA
• Ann Peterson
• Ashley Peterson
• Brianne Peterson, OTD, OTR/L
• Brooke Peterson
• Carolyn Peterson

• Chiropractor in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Chiropractor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.