Individual provider Active NPI

Peter W Unverferth

  • Chiropractor
  • Santa Fe, NM
National Provider Identifier
1568565125
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1415 Issued in NM
Practice address
1892 Plaza del Sur Dr # a
Santa Fe, NM 87505-6043
Phone
(505) 984-0934
Fax
(505) 988-8018
NPI assigned
Sep 7, 2006
Last updated
Apr 22, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1415 NM Primary

Addresses

Primary practice location

1892 Plaza del Sur Dr # a
Santa Fe, NM 87505-6043

Mailing address

1892 Plaza del Sur Dr # a
Santa Fe, NM 87505-6043
Phone (505) 984-0934

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070822000118 NM Practitioner - Chiropractic 5597857615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1925 Aspen Dr
Suite 400B
Santa Fe, NM 87505-5491
Phone (505) 984-0934

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1415NMMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pro-Active Chiropractic LLC Chiropractor CurrentSince Jan 9, 2007 Accepting new patients

Locations

1892 Plaza del Sur Dr
Ste A
Santa Fe, NM 87505
Phone (505) 984-0934

1925 Aspen Dr
Ste 400B
Santa Fe, NM 87505
Phone (505) 984-0934

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1568565125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1892 PLAZA DEL SUR DR # A",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056043",
            "telephone_number": "505-984-0934",
            "fax_number": "505-988-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1892 PLAZA DEL SUR DR # A",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056043",
            "telephone_number": "505-984-0934",
            "fax_number": "505-988-8018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNVERFERTH",
        "first_name": "PETER",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "1415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.