Individual provider Active NPI

Christopher S Peters, D.C.

  • Chiropractor
  • Bowling Green, OH
National Provider Identifier
1609935964
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3551 Issued in OH
Practice address
640 S Wintergarden Rd
Bowling Green, OH 43402-3544
Phone
(419) 353-6394
Fax
(419) 354-8341
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3551 OH Primary

Addresses

Primary practice location

640 S Wintergarden Rd
Bowling Green, OH 43402-3544

Mailing address

25197 Fox Hunt Dr
Perrysburg, OH 43551-6792
Phone (419) 344-5550

Other identifiers 3

IdentifierTypeStateIssuer
000000378878OtherOHANTHEM
7601711OtherOHAETNA
2514907MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050314000897 OH Practitioner - Chiropractic 3173578002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Frey Clinic of Chiropractic IncGroup PAC ID 2567428527, 3 clinicians

Practice addresses (Care Compare)

390 Independence Dr
Napoleon, OH 43545-9194
Phone (419) 592-7966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3551OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Frey Clinic of Chiropractic Inc Chiropractor CurrentSince Jan 15, 2019 Accepting new patients

Locations

390 Independence Dr
Napoleon, OH 43545
Phone (419) 591-6292

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1609935964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25197 FOX HUNT DR",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435516792",
            "telephone_number": "419-344-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S WINTERGARDEN RD",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434023544",
            "telephone_number": "419-353-6394",
            "fax_number": "419-354-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "CHRISTOPHER",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000378878",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7601711",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2514907",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; 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.