Active NPI
Blake Peterson, DC
- Chiropractor
- West Valley City, UT
National Provider Identifier
1962965855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 10874281-1202
- Practice address
- 1878 W 3600 S
West Valley City, UT 84119-3893 - Phone
- (801) 972-1222
- NPI assigned
- Apr 9, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 10874281-1202 | UT | Primary |
Addresses
Primary practice location
1878 W 3600 S
West Valley City, UT 84119-3893
Mailing address
1878 W 3600 S
West Valley City, UT 84119-3893
Phone (801) 972-1222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College - West, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1878 W 3600
West Valley, UT 84119-3893
Phone (801) 972-1222
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10874281-1202 | UT | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peterson Chiropractic | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- West Valley City, UT
- NPI 1134333669
-
- Chiropractor
- West Valley, UT
- NPI 1558631531
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554768000000",
"number": "1962965855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1878 W 3600 S",
"city": "WEST VALLEY CITY",
"state": "UT",
"postal_code": "841193893",
"telephone_number": "801-972-1222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1878 W 3600 S",
"city": "WEST VALLEY CITY",
"state": "UT",
"postal_code": "841193893",
"telephone_number": "801-972-1222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "BLAKE",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-09",
"last_updated": "2019-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "UT",
"license": "10874281-1202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Valley City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; 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.