Gregory J. Peterson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1992 Issued in MN

Practice address

215 2ND St SE
Ortonville, MN 56278-1537

Phone

(320) 839-2323

Fax

(320) 839-2323

NPI assigned

Oct 12, 2006

Last updated

Jan 12, 2012By the provider in NPPES

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

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Ortonville Chiropractic Clinic

  • Chiropractor
  • Ortonville, MN
  • NPI 1669599908
  Authorized official Same address or phone

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1548359243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 2ND ST SE",
            "city": "ORTONVILLE",
            "state": "MN",
            "postal_code": "562781537",
            "telephone_number": "320-839-2323",
            "fax_number": "320-839-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 2ND ST SE",
            "city": "ORTONVILLE",
            "state": "MN",
            "postal_code": "562781537",
            "telephone_number": "320-839-2323",
            "fax_number": "320-839-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "GREGORY",
        "middle_name": "J.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "1992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN PROVIDER NUMBER",
            "identifier": "230676",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "350048036",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SD MEDICAL ASSISTANCE",
            "identifier": "7602140",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIME WEST MED ASSISTANCE",
            "identifier": "030701023",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIOUX VALLEY HEALTH PLAN",
            "identifier": "20341",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIAD",
            "identifier": "391886617",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS CLINIC/GROUP NUMBER",
            "identifier": "49317PE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL PROVIDER",
            "identifier": "1B090PE",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "595727300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ortonville Area Health Services
• Ortonville Area Health Services
• Ortonville Area Health Services
• Ortonville Chiropractic Clinic
• Kristen Pearson Ash
• Tabitha Radermacher, L.AC
• Allan E Ross, MD
• Robert S Ross, MD
• Paul Rudebusch
• Bradley Runia, PT

• Chiropractor in Ortonville, MN
• Providers in Ortonville, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; 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.