Individual provider Active NPI

Troy Henry Peters, D.C.

  • Chiropractor
  • Goodyear, AZ
National Provider Identifier
1366448912
Registry record updated Apr 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7767 Issued in AZ
Practice address
1616 N Litchfield Rd
Suite 100
Goodyear, AZ 85395-1287
Phone
(623) 935-0911
Fax
(623) 935-0921
NPI assigned
Jun 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7767 AZ Primary
Nutrition Chiropractor 111NN1001X DC-29747 CA

Addresses

Primary practice location

1616 N Litchfield Rd
Suite 100
Goodyear, AZ 85395-1287

Mailing address

1616 N Litchfield Rd
Suite 100
Goodyear, AZ 85395-1252
Phone (623) 935-0911

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070108000438 AZ Practitioner - Chiropractic 7315947744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1616 N Litchfield Rd
Suite 100
Goodyear, AZ 85395-1278
Phone (623) 935-0911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-29747CAMDNutrition Chiropractor
7767AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peters Wellness Chiropractic Inc Nutrition CurrentSince Nov 1, 2006 Accepting new patients

Locations

1616 N Litchfield Rd
Ste 100
Goodyear, AZ 85395
Phone (623) 935-0911

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397779200000",
    "number": "1366448912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 N LITCHFIELD RD",
            "address_2": "SUITE 100",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853951252",
            "telephone_number": "623-935-0911",
            "fax_number": "623-935-0921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 N LITCHFIELD RD",
            "address_2": "SUITE 100",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853951287",
            "telephone_number": "623-935-0911",
            "fax_number": "623-935-0921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "TROY",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2014-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7767",
            "primary": true
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CA",
            "license": "DC-29747",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2014; 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.