Individual provider Active NPI

Linda Rene Peters, D.C.

  • Chiropractor
  • Windsor Heights, IA
National Provider Identifier
1336289792
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05812 Issued in IA
Practice address
6900 University Ave Ste 108
Windsor Heights, IA 50311-1505
Phone
(515) 274-6104
Fax
(515) 255-3355
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X A05812 IA Primary

Addresses

Primary practice location

6900 University Ave Ste 108
Windsor Heights, IA 50311-1505

Mailing address

6900 University Ave Ste 108
Windsor Heights, IA 50311-1505
Phone (515) 274-6104

Other identifiers 2

IdentifierTypeStateIssuer
49767OtherIABLUE SHIELD
0195347MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A05812IAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336289792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 UNIVERSITY AVE STE 108",
            "city": "WINDSOR HEIGHTS",
            "state": "IA",
            "postal_code": "503111505",
            "telephone_number": "515-274-6104",
            "fax_number": "515-255-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 UNIVERSITY AVE STE 108",
            "city": "WINDSOR HEIGHTS",
            "state": "IA",
            "postal_code": "503111505",
            "telephone_number": "515-274-6104",
            "fax_number": "515-255-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "LINDA",
        "middle_name": "RENE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "49767",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0195347",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor Heights, IA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.