Michael Robert Peffer, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-006953 Issued in IL

Practice address

1014 Ekstam Dr Ste 104
Bloomington, IL 61704-6382

Phone

(309) 661-0414

Fax

(309) 661-8697

NPI assigned

Jul 14, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 1991

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506556800000",
    "number": "1841216736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 WESTSHORE DR",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615501315",
            "telephone_number": "309-397-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 EKSTAM DR STE 104",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617046382",
            "telephone_number": "309-661-0414",
            "fax_number": "309-661-8697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEFFER",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2017-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-006953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5732069",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Pease
• William T Peck, DDS
• Anthony Pecora Pecora, D.D.S.,M.S.
• Paul Pedersen
• Pediatric Dental Associates of McLean County, Inc
• Edward W Pegg III, MD
• Edward W Pegg IV, M.D.
• Lori L Pegram, MD
• Julie Ann Peloza
• Leesha Peoples, CRNA

• Chiropractor in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2017; 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.