Central Division Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

CENTRAL DIVISION CHIROPRACTIC, LLC

Practice address

4049 Pennsylvania Ave Ste 100
Kansas City, MO 64111-3022

Phone

(816) 301-4355

Fax

(816) 301-6193

NPI assigned

May 10, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Ethan E Peterson, DC

Title

Chiropractor

Phone

(816) 301-4355

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1467200774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4049 PENNSYLVANIA AVE STE 100",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113022",
            "telephone_number": "816-301-4355",
            "fax_number": "816-301-6193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4049 PENNSYLVANIA AVE STE 100",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113022",
            "telephone_number": "816-301-4355",
            "fax_number": "816-301-6193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL DIVISION CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "816-301-4355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; 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.