Petterson Chiropractic Clinic PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3748 Issued in MN

Legal business name

PETTERSON CHIROPRACTIC CLINIC PA

Practice address

825 Bahls Drive
Hastings, MN 55033

Phone

(651) 480-1128

Fax

(651) 438-3929

NPI assigned

Nov 8, 2006

Organization subpart

No

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

Authorized official

Name

Chad Jeremy Petterson, DCNPI 1003986886

Title

Owner President

Phone

(651) 480-1128

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 3

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

• Chad Jeremy Petterson, DC

  • Chiropractor
  • Hastings, MN
  • NPI 1003986886
  Medicare reassignment NPD Authorized official
• Kaitlyn Marissa Harrington, DC

  • Chiropractor
  • Eagan, MN
  • NPI 1619746690
  NPD (past)
• Erick James Lundgren, D.C.

  • Chiropractor
  • Robbinsdale, MN
  • NPI 1003987876
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750451639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 BAHLS DRIVE",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "55033",
            "telephone_number": "651-480-1128",
            "fax_number": "651-438-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 BAHLS DRIVE",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "55033",
            "telephone_number": "651-480-1128",
            "fax_number": "651-438-3929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETTERSON CHIROPRACTIC CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETTERSON",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "JEREMY",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "651-480-1128",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "C03874",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "10G0179",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD #",
            "identifier": "198G8PE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• People Project LLC
• Jerome J Perra, MD
• Debra Ann Perron McCabe, OTR
• Kirsten L. Peterson, MD
• Lon B. Peterson, M.D.
• Chad Jeremy Petterson, DC
• Pharm Assist Services PLLC
• Christina Mary Pieper-Bigelow, MD
• Terra Larae Pingley, MSW, LGSW
• Kristine Pini, P.T.

• Chiropractor in Hastings, MN
• Providers in Hastings, MN by specialty
• Chiropractor in Minnesota

• 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.