Justin James Petersen, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC1401 Issued in HI

Practice address

2176 Lauwiliwili St Ste 5a
Kapolei, HI 96707-1882

Phone

(808) 425-7092

NPI assigned

Nov 25, 2005

Last updated

Jun 4, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cassandra Peterson, DC, LLC

  dba Island Family Chiropractic

  • Chiropractor
  • Aiea, HI
  • NPI 1053752535
  Medicare reassignment NPD
• Krack Chiropractic LLC

  • Chiropractor
  • Honolulu, HI
  • NPI 1417742636
  NPD Authorized official
• Ka Ola Chiropractic LLC

  • Chiropractor
  • Honolulu, HI
  • NPI 1972095834
  NPD (past) Authorized official
• Total Wellness Chiropractic and Holistic Care

  • Chiropractor
  • Weiser, ID
  • NPI 1164675740
  NPD (past)
• Total Wellness Chiropractic and Holistic Care LLC

  • Chiropractor
  • Fruitland, ID
  • NPI 1982806212
  NPD (past)

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

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1245213008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7007 HAWAII KAI DR APT C23",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968253139",
            "telephone_number": "808-426-8827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2176 LAUWILIWILI ST STE 5A",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967071882",
            "telephone_number": "808-425-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "JUSTIN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-25",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "413",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1344",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7633",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "HI",
            "license": "DC1401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabella Perez
• Briyanna Perry
• Pamela Joanne Martin Perry, RN
• Taylor W Perryman, MS, LPC, LMHC
• Taffy Perucci
• Wichai Peterson
• Barbara Ann Pfuhl, RDH
• Merin Philip
• Ami Phillips
• Sousada Phitsamay

• Chiropractor in Kapolei, HI
• Providers in Kapolei, HI by specialty
• Chiropractor in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.