Active NPI
Michael Stephan Peck, DC
- Chiropractor
- Redding, CA
National Provider Identifier
1477637130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC21866
- Practice address
- 2795 Bechelli LN
Redding, CA 96002-1924 - Phone
- (530) 222-0350
- Fax
- (530) 222-0351
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 21866 | CA | |
| Chiropractor | 111N00000X | DC21866 | CA | Primary |
Addresses
Primary practice location
2795 Bechelli LN
Redding, CA 96002-1924
Mailing address
2795 Bechelli LN
Redding, CA 96002-1924
Phone (530) 222-0350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2461836 | Other | CA | MEDICAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050404000576 | CA | Practitioner - Chiropractic | 7911954862 | Practice locations: Redding, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - West Sunnyvale, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2795 Bechelli LN
Redding, CA 96002-1924
Phone (530) 222-0350
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21866 | CA | MD | Chiropractor |
| DC21866 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739923200000",
"number": "1477637130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2795 BECHELLI LN",
"city": "REDDING",
"state": "CA",
"postal_code": "960021924",
"telephone_number": "530-222-0350",
"fax_number": "530-222-0351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2795 BECHELLI LN",
"city": "REDDING",
"state": "CA",
"postal_code": "960021924",
"telephone_number": "530-222-0350",
"fax_number": "530-222-0351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECK",
"first_name": "MICHAEL",
"middle_name": "STEPHAN",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2025-02-19",
"certification_date": "2025-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "21866",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC21866",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "2461836",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.