Active NPI
David Peterson, D.C.
- Chiropractor
- Penn Valley, CA
National Provider Identifier
1851412241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 28995
- Practice address
- 17331 Penn Valley Dr
Penn Valley, CA 95946-9340 - Phone
- (530) 615-4083
- Fax
- (530) 532-5085
- NPI assigned
- Apr 3, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6257 | MO | |
| Chiropractor | 111N00000X | 28995 | CA | Primary |
Addresses
Primary practice location
17331 Penn Valley Dr
Penn Valley, CA 95946-9340
Mailing address
17331 Penn Valley Dr
Penn Valley, CA 95946-9340
Phone (530) 615-4083
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28995 | CA | MD | Chiropractor |
| 6257 | MO | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417996800000",
"number": "1851412241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17331 PENN VALLEY DR",
"city": "PENN VALLEY",
"state": "CA",
"postal_code": "959469340",
"telephone_number": "530-615-4083",
"fax_number": "530-532-5085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17331 PENN VALLEY DR",
"city": "PENN VALLEY",
"state": "CA",
"postal_code": "959469340",
"telephone_number": "530-615-4083",
"fax_number": "530-532-5085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-03",
"last_updated": "2014-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MO",
"license": "6257",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "28995",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Penn Valley, CA
- Wendy Sue Nelsen
- New Edge Physical Therapy Inc (Wildwood Physical Therapy Inc)
- Penn Valley Fire Protection District
- Penn Valley Seventh-Day Adventist Church (Helping Hands Caregiver Resource)
- Penn Valley Union Elementary School District
- Morgan Plumb
- Karen M Rinkleib, D.C.
- Brittany Roussel, DOULA
- Keith L Sheppard, DDS
- Sierra Nevada Primary Care
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.