Tyler Peterson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1938 Issued in NE

Practice address

920 W 21St St Ste 104
South Sioux City, NE 68776-2653

Phone

(402) 412-7587

Fax

(402) 625-6108

NPI assigned

Apr 25, 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 NE

Enrollment records 1

Specialty

Chiropractic

Education

Cleveland Chiropractic College - Kansas City, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acu-Plus Chiropractic L L CGroup PAC ID 4082045919, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Acu-Plus Chiropractic LLC

  • Chiropractor
  • South Sioux City, NE
  • NPI 1982238218
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1821523184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 W 21ST ST STE 104",
            "city": "SOUTH SIOUX CITY",
            "state": "NE",
            "postal_code": "687762653",
            "telephone_number": "402-412-7587",
            "fax_number": "402-625-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 W 21ST ST STE 104",
            "city": "SOUTH SIOUX CITY",
            "state": "NE",
            "postal_code": "687762653",
            "telephone_number": "402-412-7587",
            "fax_number": "402-625-6108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-25",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott H Patrick, D.C.
• Jenny Pattee
• Linda S. Payer
• Martinique Michelle Peters, MA
• Courtney N Petersen
• Bounyaveth Phachomphon
• Tracey Ann Pick, ARNP
• Cecilia Pineda
• Susan Popken, RN
• Jamie Portillo

• Chiropractor in South Sioux City, NE
• Providers in South Sioux City, NE by specialty
• Chiropractor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.