Tina Anne-Marie Peterson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3711-012 Issued in WI

Practice address

5703 75TH St
Kenosha, WI 53142-3603

Phone

(262) 697-1363

Fax

(262) 697-1388

NPI assigned

May 2, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• BBGH Partnership

  dba Community Chiropractic

  • Chiropractor
  • Walworth, WI
  • NPI 1578644068
  NPD (past)
• Bedogne Chiropractic LLC

  • Chiropractor
  • Kenosha, WI
  • NPI 1801082813
  NPD (past)
• LP Chiropractic LLC

  • Chiropractor
  • Kenosha, WI
  • NPI 1508072836
  NPD (past)

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

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398988800000",
    "number": "1205246998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5703 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423603",
            "telephone_number": "262-697-1363",
            "fax_number": "262-697-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5703 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423603",
            "telephone_number": "262-697-1363",
            "fax_number": "262-697-1388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "TINA",
        "middle_name": "ANNE-MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-02",
        "last_updated": "2014-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3711-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig A. Peterson, D.M.D
• Karen A Peterson, M.D.
• Kristopher Wyllis Peterson, DC
• Mark A Peterson, PA-C
• Matthew D Peterson, PA-C
• John D Pettinger, M.D.
• Mary Pettit, RN
• Bethany Pfeiffer
• Elizabeth Pflug-Froh, PT
• PH Kenosha LLC (Kenosha Estates Living and Care Center)

• Chiropractor in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; 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.