Rodney W Peterson, DOCTOR OF CHIROPRACT

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

515 Issued in ND

Practice address

2800 S University Dr
Fargo, ND 58103-6030

Phone

(701) 237-0614

Fax

(701) 237-0615

NPI assigned

Oct 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1225112311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 S UNIVERSITY DR",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036030",
            "telephone_number": "701-237-0614",
            "fax_number": "701-237-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 S UNIVERSITY DR",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036030",
            "telephone_number": "701-237-0614",
            "fax_number": "701-237-0615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "RODNEY",
        "middle_name": "W",
        "credential": "DOCTOR OF CHIROPRACT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016742",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "502228200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melody R Peterson, LAC
• Michael Dean Peterson, D.D.S., M.S.
• Nancy Peterson, LPN
• Paul Peterson
• Rachael Peterson
• Samantha Peterson, LPN
• Sherrie Peterson, RN-BC
• Stephanie Peterson, M.S.
• Susan Jane Peterson, RN
• Terry A Peterson, PA-C

• Chiropractor in Fargo, ND
• Providers in Fargo, ND by specialty
• Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.

Verify at the official NPI Registry.