Petersen Chiropratic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1833 Issued in CO

Legal business name

PETERSEN CHIROPRATIC, LLC

Practice address

1923 E Kentucky Ave
Denver, CO 80209-4554

Phone

(303) 722-2273

Fax

(303) 282-7597

NPI assigned

Sep 10, 2013

Last updated

Jun 20, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dale Paul Petersen, D.C.NPI 1306906169

Title

President

Phone

(303) 722-2273

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dale Petersen, DC

  • Chiropractor
  • Denver, CO
  • NPI 1306906169
  Authorized official Same address or phone

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1457786428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 E KENTUCKY AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802094554",
            "telephone_number": "303-722-2273",
            "fax_number": "303-282-7597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 E KENTUCKY AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802094554",
            "telephone_number": "303-722-2273",
            "fax_number": "303-282-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSEN CHIROPRATIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-10",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-722-2273",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "1833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "307178",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TIN",
            "identifier": "25521",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Peters, MFTC
• Rachel Erin Peters, PT, DPT
• Sarajane Peters
• Teresa Ann Peters, RPH
• Wayne Peters, M.D.
• Amy Devanney Petersen, LCSW
• Barbara Parker Petersen, BA
• Brian Woodford Petersen, M.D.
• Claire Sophia Petersen
• Dale Petersen, DC

• Chiropractor in Denver, CO
• Providers in Denver, CO by specialty
• Chiropractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.