Active NPI
Craig Peterson, D.C.
- Chiropractor
- St George, UT
National Provider Identifier
1649436452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 6960863-1202
- Practice address
- 613 S Bluff Street, TWR 1
Suite 400
St George, UT 84770-3853 - Phone
- (435) 656-0234
- Fax
- (435) 656-2622
- NPI assigned
- Jul 31, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6960863-1202 | UT | Primary |
Addresses
Primary practice location
613 S Bluff Street, TWR 1
Suite 400
St George, UT 84770-3853
Mailing address
613 S Bluff Street TWR 1
Suite 400
St George, UT 84770-3853
Phone (435) 656-0234
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6960863-1202 | UT | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Next Level Facility LLC | Past | Accepting new patients | |
| Premier Physicians Group, PLLC | Chiropractor | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/3522/brand/1/csg/21/fhir/r4
Organizations & group practices 2
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.
-
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- Phoenix, AZ
- NPI 1558135756
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217462400000",
"number": "1649436452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "613 S BLUFF STREET TWR 1",
"address_2": "SUITE 400",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847703853",
"telephone_number": "435-656-0234",
"fax_number": "435-656-2622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "613 S BLUFF STREET, TWR 1",
"address_2": "SUITE 400",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847703853",
"telephone_number": "435-656-0234",
"fax_number": "435-656-2622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "CRAIG",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-31",
"last_updated": "2008-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "UT",
"license": "6960863-1202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.