Organization Active NPI

Peters Wellness Chiropractic Inc

  • Nutrition Chiropractor
  • Goodyear, AZ
National Provider Identifier
1629149968
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
7767 Issued in AZ
Legal business name
PETERS WELLNESS CHIROPRACTIC INC
Practice address
1616 N Litchfield Rd
Suite 210
Goodyear, AZ 85338-1252
Phone
(623) 935-0911
Fax
(623) 935-0921
NPI assigned
Nov 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Troy Henry Peters, D.C.NPI 1366448912
Title
Ceo
Phone
(623) 935-0911

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NN1001X 7767 AZ Primary
Nutrition ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NN1001X DC-29747 CA

Addresses

Primary practice location

1616 N Litchfield Rd
Suite 210
Goodyear, AZ 85338-1252

Mailing address

1616 N Litchfield Rd
Suite 210
Goodyear, AZ 85338-1252
Phone (623) 935-0911

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070108000432 AZ Part B Supplier - Clinic/Group Practice 1052311487 Receives reassigned benefits from 1 practitioner
Practice locations: Goodyear, AZ

National Provider Directory

National Provider Directory

Locations

1616 N Litchfield Rd
Ste 210
Goodyear, AZ 85395
Phone (623) 935-0911

1616 N Litchfield Rd
Ste 100
Goodyear, AZ 85395
Phone (623) 935-0911

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629149968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 N LITCHFIELD RD",
            "address_2": "SUITE 210",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853381252",
            "telephone_number": "623-935-0911",
            "fax_number": "623-935-0921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 N LITCHFIELD RD",
            "address_2": "SUITE 210",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853381252",
            "telephone_number": "623-935-0911",
            "fax_number": "623-935-0921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERS WELLNESS CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "623-935-0911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "AZ",
            "license": "7767",
            "primary": true
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "CA",
            "license": "DC-29747",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.