Individual provider Active NPI

Peter William Stephens, DC

  • Chiropractor
  • Okeechobee, FL
National Provider Identifier
1790772028
Registry record updated Aug 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0003189 Issued in FL
Practice address
375 SW 32ND St
Okeechobee, FL 34974-5919
Phone
(863) 763-0880
Fax
(863) 763-3077
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0003189 FL Primary

Addresses

Primary practice location

375 SW 32ND St
Okeechobee, FL 34974-5919

Mailing address

375 SW 32ND St
Okeechobee, FL 34974-5919
Phone (863) 763-0880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110414000300 FL Practitioner - Chiropractic 5395929475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

375 SW 32ND St
Okeechobee, FL 34974-5919

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0003189FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Peter Stephens Inc CurrentSince May 4, 1979 Accepting new patients

Locations

375 SW 32nd St
Okeechobee, FL 34974
Phone (813) 763-0880

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377820800000",
    "number": "1790772028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 SW 32ND ST",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349745919",
            "telephone_number": "863-763-0880",
            "fax_number": "863-763-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 SW 32ND ST",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349745919",
            "telephone_number": "863-763-0880",
            "fax_number": "863-763-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "PETER",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2013-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0003189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okeechobee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; 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.