Gary L. Peterson D.C.PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

GARY L. PETERSON D.C.PA

Practice address

7100 Menaul Blvd NE
Albuquerque, NM 87110-3688

Phone

(505) 883-5858

Fax

(505) 883-0010

NPI assigned

Apr 10, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Gary Lee Petersn, D.C.

Title

Chiropractic Physician

Phone

(505) 883-5858

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334016000000",
    "number": "1871859249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 MENAUL BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103688",
            "telephone_number": "505-883-5858",
            "fax_number": "505-883-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 MENAUL BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103688",
            "telephone_number": "505-883-5858",
            "fax_number": "505-883-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY L. PETERSON D.C.PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-10",
        "last_updated": "2012-04-10",
        "status": "A",
        "authorized_official_last_name": "PETERSN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "505-883-5858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K7169",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Anne Garrison, M.S. CCC-SLP
• Paul Daniel Garver, LMHC
• Consuelo Garvey-Sierra, LISW
• Kelly J Garvin
• Gary D Prant
• Alyssa Garza
• Anastasia Garza, LVN
• Araceli Ivet Garza, APRN-CNP, PMHNP-BC
• Cristian Garza
• Gloria Veronica Garza, MS, RD, LD

• Chiropractor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Chiropractor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; 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.