Brad Niel Peterson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

176210-1202 Issued in UT

Practice address

10358 S Redwood Rd
South Jordan, UT 84095-9339

Phone

(801) 254-9400

Fax

(801) 254-5739

NPI assigned

Jul 19, 2006

Last updated

Dec 16, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Specialty

Chiropractic

Education

Western States College of Chiropractic, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southwest Chiropractic, Inc.

  • Chiropractor
  • South Jordan, UT
  • NPI 1588967301
  Medicare reassignment NPD Authorized official
• Southwest Personal Injury

  • Chiropractor
  • Bluffdale, UT
  • NPI 1649706615
  Authorized official Same address or phone
• Life Source Chiropractic, PLLC

  • Chiropractor
  • West Jordan, UT
  • NPI 1306470430
  NPD

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1659390417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10358 S REDWOOD RD",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840959339",
            "telephone_number": "801-254-9400",
            "fax_number": "801-254-5739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10358 S REDWOOD RD",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840959339",
            "telephone_number": "801-254-9400",
            "fax_number": "801-254-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "BRAD",
        "middle_name": "NIEL",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "176210-1202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "612239",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870503754002",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler Perry, PA-C, ATC
• Personal Injury Center MD LLC
• Charli Danielle Peters, A.P.R. N
• Petersen Dental LLC
• Sarah Connors Petersen, MD
• Catherine Peterson
• Johnathon Dahlin Peterson, LCMHC, LPC
• Matthew Wade Peterson, D.C.
• Mitchell Alan Peterson, MD
• Valerie Peterson

• Chiropractor in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Chiropractor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; 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.