Brooke Sara Peterson, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6732 Issued in MN

Practice address

194 Progress Way
Spicer, MN 56288-5000

Phone

(651) 239-3806

NPI assigned

May 11, 2020

Last updated

May 11, 2020By the provider in NPPES

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

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

National College of Chiropractic, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peterson Wellness Clinic P.a.Group PAC ID 7113348368, 2 clinicians

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

• Peterson Wellness Clinic P.a.

  dba Green Lake Chiropractic Center

  • Chiropractor
  • Spicer, MN
  • NPI 1639791932
  Medicare reassignment Care Compare group NPD
• Ametrine Mental Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Spicer, MN
  • NPI 1902526437
  NPD

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1326660622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 PROGRESS WAY",
            "city": "SPICER",
            "state": "MN",
            "postal_code": "562885000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 PROGRESS WAY",
            "city": "SPICER",
            "state": "MN",
            "postal_code": "562885000",
            "telephone_number": "651-239-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "BROOKE",
        "middle_name": "SARA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-11",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Kretschmar, PT, DPT
• Benjamin Marvin Olson
• Stephanie Olson, PMHNP-BC
• Paynesville Area Hospital District (Green Lake Medical Clinic)
• Peterson Wellness Clinic P.a. (Green Lake Chiropractic Center)
• Zachary Leland Peterson, DC
• Prairie Community Services
• Karrie Recker, AU.D.
• Haley Mae Reeves, DC
• Zachary Reierson, DDS

• Chiropractor in Spicer, MN
• Providers in Spicer, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.