Individual provider Active NPI

Gretchen Gilbertson Peterson, D.C.

  • Chiropractor
  • Albuquerque, NM
National Provider Identifier
1548328768
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1046 Issued in NM
Practice address
9601 Sierra Vista CT NE
Suite a
Albuquerque, NM 87111-3422
Phone
(505) 299-4446
Fax
(505) 275-8505
NPI assigned
Dec 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1046 NM Primary

Addresses

Primary practice location

9601 Sierra Vista CT NE
Suite a
Albuquerque, NM 87111-3422

Mailing address

9601 Sierra Vista CT NE
Suite a
Albuquerque, NM 87111-3422
Phone (505) 299-4446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040119000761 NM Practitioner - Chiropractic 4284535568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9601 Sierra Vista CT NE
Albuquerque, NM 87111-3461
Phone (505) 299-4446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1046NMMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Sandia Chiropractic Care PC Chiropractor CurrentSince Feb 26, 2007 Accepting new patients

Locations

9601 Sierra Vista Ct NE
Albuquerque, NM 87111
Phone (505) 299-4446

9601 Sierra Vista Ct NE
Ste A
Albuquerque, NM 87111
Phone (505) 299-4446

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548328768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 SIERRA VISTA CT NE",
            "address_2": "SUITE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113422",
            "telephone_number": "505-299-4446",
            "fax_number": "505-275-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 SIERRA VISTA CT NE",
            "address_2": "SUITE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113422",
            "telephone_number": "505-299-4446",
            "fax_number": "505-275-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "GRETCHEN",
        "middle_name": "GILBERTSON",
        "name_prefix": "Mrs.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "1046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.