Individual provider Active NPI

Peter Harry Dyer, D.C.

  • Chiropractor
  • Monticello, IN
National Provider Identifier
1881706323
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08000478A Issued in IN
Practice address
710 W Fisher St
Monticello, IN 47960-1737
Phone
(574) 583-5418
Fax
(574) 583-8991
NPI assigned
Aug 31, 2006
Last updated
Sep 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08000478A IN Primary

Addresses

Primary practice location

710 W Fisher St
Monticello, IN 47960-1737

Mailing address

6232 E Woodhaven CT
Monticello, IN 47960-1492
Phone (574) 870-0022

Other identifiers 1

IdentifierTypeStateIssuer
100262550AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120201000231 IN Practitioner - Chiropractic 7416114509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

710 W Fisher St
Monticello, IN 47960-1737
Phone (574) 538-5418

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08000478AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Peter H. Dyer, DC, Inc. Chiropractor CurrentSince Jan 31, 2012 Accepting new patients

Locations

124 S Main St
Monticello, IN 47960
Phone (574) 583-5418

710 W Fisher St
Monticello, IN 47960
Phone (574) 538-5418

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1881706323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6232 E WOODHAVEN CT",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479601492",
            "telephone_number": "574-870-0022",
            "fax_number": "574-583-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 W FISHER ST",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479601737",
            "telephone_number": "574-583-5418",
            "fax_number": "574-583-8991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "PETER",
        "middle_name": "HARRY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08000478A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100262550A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.