NPIMap

Individual provider Active NPI

Julie Peterson, DC

  • Chiropractor
  • Lakewood, WA
National Provider Identifier
1629035167
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60191318 Issued in WA
Practice address
7504 86TH Street SW, Suite 150
Vital Family Chiropractic
Lakewood, WA 98498
Phone
(843) 200-9400
Fax
(888) 411-8529
NPI assigned
Apr 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2166 SC
Chiropractor 111N00000X CH60191318 WA Primary

Addresses

Primary practice location

7504 86TH Street SW, Suite 150
Vital Family Chiropractic
Lakewood, WA 98498

Mailing address

7504 86TH Street SW, Suite 150
Vital Family Chiropractic
Lakewood, WA 98498
Phone (843) 200-9400

Other identifiers 2

IdentifierTypeStateIssuer
CH2167MedicaidSC
U7089OtherSCUPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jpete LLC Chiropractor PastSince Jan 1, 1990 Accepting new patients
Epb Inc Chiropractor Past Accepting new patients
James Island Family Chiropractic, LLC. Chiropractor PastSince Jan 16, 2012 Accepting new patients

Organizations & group practices 3

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1629035167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7504 86TH STREET SW, SUITE 150",
            "address_2": "VITAL FAMILY CHIROPRACTIC",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "98498",
            "telephone_number": "843-200-9400",
            "fax_number": "888-411-8529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7504 86TH STREET SW, SUITE 150",
            "address_2": "VITAL FAMILY CHIROPRACTIC",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "98498",
            "telephone_number": "843-200-9400",
            "fax_number": "888-411-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JULIE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2166",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60191318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH2167",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "U7089",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.