Active NPI
Boyd M Peterson, DC
- Orthopedic Chiropractor
- Milwaukee, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Chiropractor
- License
- 2800
- Practice address
- 1155 N Mayfair Rd
Spine Care Clinic at Plank Road
Milwaukee, WI 53226-3421 - Phone
- (414) 955-7199
- Fax
- (414) 955-0110
- NPI assigned
- May 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2800 | WI | |
| Sports Physician Chiropractor | 111NS0005X | 2800 | WI | |
| Orthopedic Chiropractor | 111NX0800X | 2800 | WI | Primary |
Addresses
Primary practice location
1155 N Mayfair Rd
Spine Care Clinic at Plank Road
Milwaukee, WI 53226-3421
Mailing address
1155 N Mayfair Rd
Spine Care Clinic at Plank Road
Milwaukee, WI 53226-3421
Phone (414) 955-7199
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007000261F | Other | HUMANA | |
| 1417901422 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- National College of Chiropractic, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1155 N Mayfair Rd
FL 2
Milwaukee, WI 53226-3462
Phone (414) 955-4263
8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666
8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.99 of 100
- Quality
- 82.81
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.15
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2800 | WI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Medical College of Wisconsin, Inc. | Chiropractor | Current | Accepting new patients |
| The Medical College of Wisconsin Inc | Past | Accepting new patients |
Locations
10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080
1155 N Mayfair Rd
Ste B
Milwaukee, WI 53226
Phone (414) 456-7199
Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990
Interoperability endpoints
- bpetersondc5502@direct.froedtert.com
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
Chiropractor
-
- Case Management Agency
- Milwaukee, WI
- NPI 1649521105
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768348800000",
"number": "1417901422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1155 N MAYFAIR RD",
"address_2": "SPINE CARE CLINIC AT PLANK ROAD",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263421",
"telephone_number": "414-955-7199",
"fax_number": "414-955-0110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1155 N MAYFAIR RD",
"address_2": "SPINE CARE CLINIC AT PLANK ROAD",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263421",
"telephone_number": "414-955-7199",
"fax_number": "414-955-0110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "BOYD",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-22",
"last_updated": "2026-01-14",
"certification_date": "2026-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "2800",
"primary": false
},
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "WI",
"license": "2800",
"primary": false
},
{
"code": "111NX0800X",
"taxonomy_group": "",
"desc": "Chiropractor, Orthopedic",
"state": "WI",
"license": "2800",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "007000261F",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1417901422",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.