Individual provider Active NPI

Rand A Petersen, D.C.

  • Chiropractor
  • Kearney, NE
National Provider Identifier
1265475073
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
897 Issued in NE
Practice address
3812 4TH Ave
Kearney, NE 68845-2832
Phone
(308) 237-7700
Fax
(308) 236-7605
NPI assigned
Jun 13, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 897 NE Primary

Addresses

Primary practice location

3812 4TH Ave
Kearney, NE 68845-2832

Mailing address

3812 4TH Ave
Kearney, NE 68845-2832
Phone (308) 237-7700

Other identifiers 3

IdentifierTypeStateIssuer
09504OtherNEBCBS OF NE
22396OtherNEMIDLAND'S CHOICE NETWORK
47070724500MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090324000113 NE Practitioner - Chiropractic 6800953621 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Chiropractic and Tissue Rehabilitation LLCGroup PAC ID 2961682794, 5 clinicians

Practice addresses (Care Compare)

3812 4TH Ave
Kearney, NE 68845-2832
Phone (308) 237-7700

4715 2ND Ave
Kearney, NE 68847-2417
Phone (308) 455-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
897NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Petersen Chiropractic Center PC Chiropractor CurrentSince Oct 1, 2012 Accepting new patients
Elite Chiropractic & Tissue Rehabilitation, LLC CurrentSince Mar 17, 2026 Accepting new patients

Locations

3812 4th Ave
Kearney, NE 68845
Phone (308) 237-7700

4715 2nd Ave
Kearney, NE 68847
Phone (308) 455-1500

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1265475073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3812 4TH AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452832",
            "telephone_number": "308-237-7700",
            "fax_number": "308-236-7605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3812 4TH AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452832",
            "telephone_number": "308-237-7700",
            "fax_number": "308-236-7605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "RAND",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NE",
            "identifier": "09504",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLAND'S CHOICE NETWORK",
            "identifier": "22396",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47070724500",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.