Kristopher Bryan Peterson, D.C.

Primary specialty

Internist ChiropractorTaxonomy code 111NI0900X

License

1525 Issued in OR

Practice address

1002 W Elm Ave
Hermiston, OR 97838-2711

Phone

(541) 567-6277

Fax

(541) 567-9055

NPI assigned

Feb 22, 2007

Sex

Male

Sole proprietor

Yes

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 OR

Enrollment records 1

Specialty

Chiropractic

Education

Western States College of Chiropractic, 1979

Medicare assignment

May accept Medicare assignment

Group practices

Kristopher B Peterson DC PCGroup PAC ID 2365439262, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Shepherd Medical Center Hospital, Hermiston, OR, CCN 381325

Medicare enrollment (NPD)

Enrolled

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.

• Kristopher B Peterson, DC PC

  • Chiropractor
  • Hermiston, OR
  • NPI 1437273497
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Good Shepherd Health Care System

  • Critical Access Hospital
  • Hermiston, OR
  • NPI 1295789667
  Care Compare affiliation

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790810844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 W ELM AVE",
            "address_2": "PO BOX 211",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "978382711",
            "telephone_number": "541-567-6277",
            "fax_number": "541-567-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 W ELM AVE",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "978382711",
            "telephone_number": "541-567-6277",
            "fax_number": "541-567-9055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KRISTOPHER",
        "middle_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NI0900X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Internist",
            "state": "OR",
            "license": "1525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Scott Pearson, PHARMD
• Toby Allen Penner, CRNA, MSN
• Perfectly Broken LLC
• Julian Petersen, DDS
• Kim A Peterson, DO
• Twila Dawn Phillips, DIRECTOR
• Physical Medicine & Performance LLC
• Chanty Pin
• Pinnacle Sleep of Oregon
• Pinnacle Sleep of Oregon LLC

• Internist Chiropractor in Hermiston, OR
• Providers in Hermiston, OR by specialty
• Internist Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.