Timothy Dee Petersen, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

21088 Issued in CA

Practice address

2351 Sunset Blvd
Ste 120
Rocklin, CA 95765

Phone

(916) 624-2500

Fax

(916) 624-4196

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Suzanne Petersen Chiropractic

  dba Stanford Ranch Chriopractic Clinic

  • Chiropractor
  • Rocklin, CA
  • NPI 1427302355
  Authorized official Same address or phone
• Timothy D Petersen Chiropractic Inc.

  dba Stanford Ranch Chiropractic

  • Chiropractor
  • Rocklin, CA
  • NPI 1366722142
  Authorized official Same address or phone

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1891853453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2351 SUNSET BLVD",
            "address_2": "STE 120",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "95765",
            "telephone_number": "916-624-2500",
            "fax_number": "916-624-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 SUNSET BLVD",
            "address_2": "STE 120",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "95765",
            "telephone_number": "916-624-2500",
            "fax_number": "916-624-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "TIMOTHY",
        "middle_name": "DEE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "21088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HSHP",
            "identifier": "TP1003401",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "DC0210880 5422",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Perkins
• Jessica Kathrine Perkins
• Kimberly H Perkins, MD
• Andrea Perkiss
• Suzanne Marie Petersen, D.C.
• Dennis Roy Peterson, DDS
• Keisha Michelle Peterson
• Monty Roe Peterson, M.D.
• Sarah Peterson
• Myloan Pham, RDHAP

• Chiropractor in Rocklin, CA
• Providers in Rocklin, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; 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.