Charlotte Proactive Peters DC PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3772 Issued in NC

Legal business name

CHARLOTTE PROACTIVE PETERS DC PC

Practice address

11220 Golf Links Drive
Charlotte, NC 28277

Phone

(704) 901-7192

NPI assigned

Mar 15, 2018

Last updated

Mar 15, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stewart Peters, DCNPI 1093994816

Title

Chiropractor

Phone

(704) 901-7192

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stewart Todd Peters, D.C.

  • Chiropractor
  • Charlotte, NC
  • NPI 1093994816
  Authorized official Same address or phone

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521072000000",
    "number": "1154824274",
    "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": [],
    "basic": {
        "organization_name": "CHARLOTTE PROACTIVE PETERS DC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-15",
        "last_updated": "2018-03-15",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "STEWART",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "704-901-7192",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3772",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P15776",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.