Active NPI
Lidia Theolinda Petersen, DC
- Chiropractor
- Seward, AK
National Provider Identifier
1174605141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 384
- Practice address
- 11694 Seward Hwy
Ste C
Seward, AK 99664 - Phone
- (907) 224-8680
- Fax
- (907) 224-8910
- NPI assigned
- Oct 19, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 384 | AK | Primary |
Addresses
Primary practice location
11694 Seward Hwy
Ste C
Seward, AK 99664
Mailing address
11694 Seward Hwy
Ste C
Seward, AK 99664
Phone (907) 224-8680
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 |
|---|---|---|---|
| 384 | AK | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arctic Chiropractic Seward | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Seward, AK
- NPI 1962026021
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196812800000",
"number": "1174605141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11694 SEWARD HWY",
"address_2": "STE C",
"city": "SEWARD",
"state": "AK",
"postal_code": "99664",
"telephone_number": "907-224-8680",
"fax_number": "907-224-8910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11694 SEWARD HWY",
"address_2": "STE C",
"city": "SEWARD",
"state": "AK",
"postal_code": "99664",
"telephone_number": "907-224-8680",
"fax_number": "907-224-8910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "LIDIA",
"middle_name": "THEOLINDA",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-19",
"last_updated": "2007-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AK",
"license": "384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seward, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.