Kristofor Mikael Peterson, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR007503 Issued in GA

Practice address

587 Virginia Ave NE
Ste 4
Atlanta, GA 30306-3695

Phone

(404) 477-7911

Fax

(404) 477-0750

NPI assigned

Jan 29, 2007

Sex

Male

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

Enrolled in GA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Virginia Hill Chiropractic PC

  • Chiropractor
  • Atlanta, GA
  • NPI 1790578128
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205972304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 DELIA DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333318",
            "telephone_number": "404-668-8719",
            "fax_number": "404-477-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 VIRGINIA AVE NE",
            "address_2": "STE 4",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303063695",
            "telephone_number": "404-477-7911",
            "fax_number": "404-477-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KRISTOFOR",
        "middle_name": "MIKAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR007503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Justin Peterson, MD
• Jenna Peterson
• Judy Garrett Peterson, RPH
• Kathryn Marie Peterson, PHD
• Kristen Peterson, LAT, ATC
• Leigh Ann Peterson, LPC, CEAP, SAP
• Mary Peterson, CRNA
• Michael Peterson, AA
• Quendall Peterson, RPH
• Ryan Brent Peterson, M.D.

• Chiropractor in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.