Individual provider Active NPI

Jace Alan Peters, D.C.

  • Chiropractor
  • Omaha, NE
National Provider Identifier
1861865735
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1859 Issued in NE
Practice address
15615 Pacific St
Suite #106
Omaha, NE 68118-2118
Phone
(403) 933-4447
NPI assigned
Nov 2, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1859 NE Primary

Addresses

Primary practice location

15615 Pacific St
Suite #106
Omaha, NE 68118-2118

Mailing address

4909 Cass St
Omaha, NE 68132-2912
Phone (712) 520-2311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160225000886 NE Practitioner - Chiropractic 4385949528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12828 Augusta Ave
Omaha, NE 68144-3733
Phone (402) 933-4366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1859NEMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Omne Chiropractic LLC Chiropractor CurrentSince Oct 24, 2017 Accepting new patients

Locations

15615 Pacific St
Ste 106
Omaha, NE 68118
Phone (402) 933-4447

12828 Augusta Ave
Omaha, NE 68144
Phone (402) 933-4366

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1446422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1861865735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 CASS ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681322912",
            "telephone_number": "712-520-2311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15615 PACIFIC ST",
            "address_2": "SUITE #106",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681182118",
            "telephone_number": "403-933-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JACE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-02",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; 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.