Trevor John Peterson, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1745 Issued in NE

Practice address

4715 2ND Ave
Kearney, NE 68847-2417

Phone

(308) 455-1500

Fax

(308) 455-1502

NPI assigned

Jan 7, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elite Chiropractic and Tissue Rehabilitation LLCGroup PAC ID 2961682794, 5 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.

• Elite Chiropractic & Tissue Rehabilitation, LLC

  • Clinic/Center
  • Kearney, NE
  • NPI 1295036630
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1801133186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4715 2ND AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688472417",
            "telephone_number": "308-455-1500",
            "fax_number": "308-455-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4715 2ND AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688472417",
            "telephone_number": "308-455-1500",
            "fax_number": "308-455-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "TREVOR",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-07",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1228",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Peterson, FNP-C
• Lauren Peterson, PHARMD
• Lena Peterson
• Myles Peterson
• Sherrilyn Denise Peterson, LMHP
• Nicole Lynne Peteson, LCSW
• Amber Pfeiffer, PLMHP
• Amanda Jean Phillips
• Katelyn B Phillips, PA-C
• William Kayden Phillips

• Chiropractor in Kearney, NE
• Providers in Kearney, NE by specialty
• Chiropractor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.