Chisholm Trail Clinic of Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

11510 Issued in TX

Legal business name

CHISHOLM TRAIL CLINIC OF CHIROPRACTIC

Practice address

731 S Colorado St
Lockhart, TX 78644-3103

Phone

(512) 668-4163

NPI assigned

Sep 22, 2010

Last updated

Sep 22, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ronald James Peterson, D.C.NPI 1205143948

Title

Chiropractor

Phone

(512) 668-4163

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ronald James Peterson, D.C.

  • Chiropractor
  • Lockhart, TX
  • NPI 1205143948
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285113600000",
    "number": "1578871653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 PAINTBRUSH DR",
            "city": "LOCKHART",
            "state": "TX",
            "postal_code": "786443087",
            "telephone_number": "512-668-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 S COLORADO ST",
            "city": "LOCKHART",
            "state": "TX",
            "postal_code": "786443103",
            "telephone_number": "512-668-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHISHOLM TRAIL CLINIC OF CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-22",
        "last_updated": "2010-09-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "512-668-4163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Caton, M.A., LPC
• Manuel Cavazos
• Central Texas Welllness Center, L.L.C. (Lockhart Rehab & Wellness Center)
• Charles E. Laurence MD
• Marissa Ann Childress, LCSW
• City of Lockhart
• Cheyanne Clifton
• Community Action, Inc. of Central Texas
• Community Health Centers of South Central Texas Inc. (Lockhart Family Practice Center)
• Connect Transit LLC

• Chiropractor in Lockhart, TX
• Providers in Lockhart, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.