Petersen Family Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC1759 Issued in TN

Legal business name

PETERSEN FAMILY CHIROPRACTIC

Practice address

807 E Jackson Blvd Ste 2
Jonesborough, TN 37659-1507

Phone

(423) 753-4964

NPI assigned

Mar 14, 2007

Last updated

Jan 4, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Howard Petersen, DCNPI 1528168382

Title

Owner

Phone

(423) 753-4964

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Howard Gale Petersen, DC

  • Chiropractor
  • Jonesborough, TN
  • NPI 1528168382
  NPD (past) Authorized official

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199404800000",
    "number": "1841323276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 E JACKSON BLVD STE 2",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376591507",
            "telephone_number": "423-753-4964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 E JACKSON BLVD STE 2",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376591507",
            "telephone_number": "423-753-4964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSEN FAMILY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2008-01-04",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-753-4964",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC1759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3971212",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "4100327",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00218796",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anisha Patel
• Patrick D. Shorter (Jonesborough Eye Clinic)
• Morris Patton
• Maureen J. Peacock, FNP
• John C. Pennington, M.A., CCC-SLP
• Howard Gale Petersen, DC
• Abigail Rae Phillips, LMSW
• Susan Moore Phillips, RN
• Anna Lauren Pierce
• Barbara W Porteous

• Chiropractor in Jonesborough, TN
• Providers in Jonesborough, TN by specialty
• Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.