Jennifer Lynn Petersen, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

A06013 Issued in IA

Practice address

128 6TH Ave S
Clinton, IA 52732-4103

Phone

(563) 243-1268

NPI assigned

Jan 10, 2006

Sex

Female

Sole proprietor

No

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 IA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chiropractic Health Care Center Inc

  • Chiropractor
  • Clinton, IA
  • NPI 1881881142
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199059200000",
    "number": "1841279890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 6TH AVE S",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527324103",
            "telephone_number": "563-243-1268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 6TH AVE S",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527324103",
            "telephone_number": "563-243-1268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2007-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A06013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1168062",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Mary Pebelske
• Brian W Peck, OD
• Rebecca L Peck, OD
• Bobbi Leanne Pennock
• Jorge H Perez-Cardona, M.D.
• Reese Raymond Petersen, DC
• Mara Lynn Peth, PA-C
• Jenna Pike
• Pinnacle Integrative Healthcare, PLLC (Pinnacle Integrative Healthcare)
• Pinnacle Outreach, Inc. (Pinnacle Sport & Spine Clinic)

• Chiropractor in Clinton, IA
• Providers in Clinton, IA by specialty
• Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.