Andrew F Pesta, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301010520 Issued in MI

Practice address

2100 Water St
Port Huron, MI 48060-2543

Phone

(810) 982-2700

Fax

(810) 982-5194

NPI assigned

Apr 6, 2017

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

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2017

Medicare assignment

May accept Medicare assignment

Group practices

Lakeview Chiropractic IncGroup PAC ID 6709894603, 7 clinicians

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 and National Provider Directory roles.

• Lakeview Chiropractic Inc

  • Chiropractor
  • Port Huron, MI
  • NPI 1841348695
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1689107682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 WATER ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480602543",
            "telephone_number": "810-982-2700",
            "fax_number": "810-982-5194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 WATER ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480602543",
            "telephone_number": "810-982-2700",
            "fax_number": "810-982-5194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESTA",
        "first_name": "ANDREW",
        "middle_name": "F",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-06",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Periodontic Associates of Port Huron
• Cindy J Perkins
• Maloree Blayke Perkins
• Perry Drug Stores Inc and Subsidiaries
• Shawn Perry
• Jamie Lynn Peterson, BA
• Lacey Pettee
• Christina M Petzel, LPC
• Nancy A Pfeifer, LBSW
• Alicia Rae Phillips, LLMSW

• Chiropractor in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.