Active NPI
Andrew Eric Peterson, DC
- Chiropractor
- Pismo Beach, CA
National Provider Identifier
1144337338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC 16477
- Practice address
- 1251 Shell Beach Rd
Pismo Beach, CA 93449 - Phone
- (805) 773-1251
- Fax
- (804) 773-3961
- NPI assigned
- Aug 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC 16477 | CA | Primary |
Addresses
Primary practice location
1251 Shell Beach Rd
Pismo Beach, CA 93449
Mailing address
1251 Shell Beach Rd
PO Box 3407
Pismo Beach, CA 93449
Phone (805) 773-1251
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC 16477 | CA | MD | Chiropractor |
| 16477 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210118400000",
"number": "1144337338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1251 SHELL BEACH RD",
"address_2": "PO BOX 3407",
"city": "PISMO BEACH",
"state": "CA",
"postal_code": "93449",
"telephone_number": "805-773-1251",
"fax_number": "804-773-3961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1251 SHELL BEACH RD",
"city": "PISMO BEACH",
"state": "CA",
"postal_code": "93449",
"telephone_number": "805-773-1251",
"fax_number": "804-773-3961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "ANDREW",
"middle_name": "ERIC",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-24",
"last_updated": "2008-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC 16477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pismo Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.