James Tyler Petersen, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

7779072-1202 Issued in UT

Practice address

657 W 200 N
Cedar City, UT 84720-2408

Phone

(435) 592-4845

NPI assigned

Oct 15, 2010

Last updated

Mar 20, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Medicare enrollment (NPD)

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.

• Arctic Chiropractic & Physical Medicine Eagle River LLC

  • Chiropractor
  • Eagle River, AK
  • NPI 1891198875
  Medicare reassignment NPD
• Bristlecone Chiropractic PLLC

  • Chiropractor
  • Cedar City, UT
  • NPI 1336447804
  Authorized official Same address or phone
• Chiro One Wellness Center of Eagle River LLC

  • Chiropractor
  • Eagle River, AK
  • NPI 1396437463
  NPD
• Elemental Wellness & Chiropractic

  dba Ewc

  • Chiropractor
  • Weiser, ID
  • NPI 1366712077
  NPD (past)

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332201600000",
    "number": "1134439755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 W 200 N",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847202408",
            "telephone_number": "435-592-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 W 200 N",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847202408",
            "telephone_number": "435-592-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "JAMES",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-15",
        "last_updated": "2012-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1429",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "7779072-1202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "U000073714",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Perez
• Amber Renae Perkins
• Bryce Daniel Perkins, DO
• Sarah Persha, MA, CMHC
• Richard Dwain Persons, PA-C MPAS
• Alex Peterson
• Kyle Peterson, LCMHC
• Terasa Lynn Peterson
• Trevor Justin Peterson, NP-C
• Kelcie Petty

• Chiropractor in Cedar City, UT
• Providers in Cedar City, UT by specialty
• Chiropractor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; 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.