Timothy W. Peterson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

7180 Issued in TX

Practice address

4230 Gardendale St
BLDG 201
San Antonio, TX 78229-3475

Phone

(210) 691-2747

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1995

Medicare assignment

May accept Medicare assignment

Group practices

Dr Tim Peterson PLLCGroup PAC ID 7113277633, 2 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 and National Provider Directory roles.

• Dr. Tim Peterson, PLLC

  • Chiropractor
  • San Antonio, TX
  • NPI 1902391121
  Medicare reassignment Care Compare group NPD Authorized official
• Innate Solutions PC

  • Chiropractor
  • Austin, TX
  • NPI 1477695609
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306800000000",
    "number": "1548312382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4230 GARDENDALE",
            "address_2": "BLDG 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-691-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 GARDENDALE ST",
            "address_2": "BLDG 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293475",
            "telephone_number": "210-691-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "TIMOTHY",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2011-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "7180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Emma Peterson
• Richard Matthew Peterson, M.D., M.P.H.
• Sandra H. Peterson, LPC, NCC
• Stephanie E Peterson, LPC
• Tim Peterson, PSY.D.
• Ward W Peterson, D.C.
• James Daniel Petley, DO
• Leila Petok
• F Charles Petr Jr., MD
• Petra Health, Inc.

• Chiropractor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; 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.