Eathyn Peterson, DC, ATC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

9389 Issued in AZ

Practice address

24700 N 67TH Ave
Peoria, AZ 85383-4250

Phone

(623) 259-3458

NPI assigned

Sep 22, 2014

Last updated

Sep 19, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Afc of Surprise, PLLCGroup PAC ID 9133522675, 12 clinicians

Afc of Peoria PLLCGroup PAC ID 1052557337, 6 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.

• Afc of Peoria, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Peoria, AZ
  • NPI 1154668044
  Medicare reassignment Care Compare group NPD
• Afc of Surprise, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Surprise, AZ
  • NPI 1255912721
  Medicare reassignment Care Compare group NPD
• Afc of East Mesa, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Mesa, AZ
  • NPI 1972256857
  Medicare reassignment NPD
• Afc of Phoenix, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
  • NPI 1619392362
  Medicare reassignment NPD
• Afc of Tempe PLLC

  • Physical Medicine & Rehabilitation Physician
  • Tempe, AZ
  • NPI 1255879854
  Medicare reassignment NPD
• Afc Physical Medicine of Desert Ridge,PLLC

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
  • NPI 1669731303
  Medicare reassignment NPD
• Afc Physical Medicine of Gilbert, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Gilbert, AZ
  • NPI 1528345881
  Medicare reassignment NPD
• Afc Physical Medicine of Mesa, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Mesa, AZ
  • NPI 1659645679
  Medicare reassignment NPD
• Afc Physical Medicine of San Tan Valley, PLLC

  • Physical Medicine & Rehabilitation Physician
  • San Tan Valley, AZ
  • NPI 1457638603
  Medicare reassignment NPD
• Life Clinic of Az PC

  • Chiropractor
  • Phoenix, AZ
  • NPI 1750931267
  Medicare reassignment NPD

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

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1376945360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26127 N 121ST AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853835801",
            "telephone_number": "406-925-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24700 N 67TH AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853834250",
            "telephone_number": "623-259-3458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "EATHYN",
        "credential": "DC, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-22",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "UT",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "9389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geoffrey Thomas Pesanka, PHARMD
• Pet Scan Arizona LLC
• Marc A Petein, M.D.
• Jennifer Nicole Peters, NP
• Georgia Marie Peterson-Houle, DDS
• Robert Joseph Petruncola I, MA
• L Staffan Pettersson, MD
• Jamie Petze
• Nadisha Pfaff, FNP
• Kimberly Thanh Pham

• Chiropractor in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.