Organization Active NPI

Peregrine Health Services

  • Chiropractor
  • Jonesboro, AR
National Provider Identifier
1922370113
Registry record updated Feb 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1415 Issued in AR
Legal business name
PEREGRINE HEALTH SERVICES
Practice address
2218 Race St
Jonesboro, AR 72401-7217
Phone
(870) 935-9100
NPI assigned
Feb 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2012

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

Authorized official

Name
Dr. Debra Lynn Callahan, DCNPI 1457431652
Title
President
Phone
(870) 935-9100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 1415 AR Primary

Addresses

Primary practice location

2218 Race St
Jonesboro, AR 72401-7217

Mailing address

2218 Race St
Jonesboro, AR 72401-7217
Phone (870) 935-9100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121115000213 AR Part B Supplier - Clinic/Group Practice 5698926822 Receives reassigned benefits from 1 practitioner
Practice locations: Jonesboro, AR

National Provider Directory

National Provider Directory

Locations

2218 Race St
Jonesboro, AR 72401
Phone (870) 336-3940

901 S Church St
Ste A
Jonesboro, AR 72401
Phone (870) 935-9100

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328140800000",
    "number": "1922370113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2218 RACE ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017217",
            "telephone_number": "870-935-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2218 RACE ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017217",
            "telephone_number": "870-935-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEREGRINE HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-02",
        "last_updated": "2012-02-02",
        "status": "A",
        "authorized_official_last_name": "CALLAHAN",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-935-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "1415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.