Active NPI
Debra Sue Peterson, DC
- Chiropractor
- Orange, CA
National Provider Identifier
1841357548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 15844
- Practice address
- 1952 N Tustin St
Orange, CA 92865-4644 - Phone
- (714) 283-2105
- Fax
- (714) 283-2113
- NPI assigned
- Jan 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 15844 | CA | Primary |
Addresses
Primary practice location
1952 N Tustin St
Orange, CA 92865-4644
Mailing address
1952 N Tustin St
Orange, CA 92865-4644
Phone (714) 283-2105
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150515001590 | CA | Practitioner - Chiropractic | 6305166299 | Practice locations: Orange, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Cleveland Chiropractic College - Los Angeles, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1025 E Chapman Ave
Orange, CA 92866-2110
Phone (714) 283-2105
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15844 | CA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841357548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1952 N TUSTIN ST",
"city": "ORANGE",
"state": "CA",
"postal_code": "928654644",
"telephone_number": "714-283-2105",
"fax_number": "714-283-2113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1952 N TUSTIN ST",
"city": "ORANGE",
"state": "CA",
"postal_code": "928654644",
"telephone_number": "714-283-2105",
"fax_number": "714-283-2113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "DEBRA",
"middle_name": "SUE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "15844",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.