Kelly A Peterson, DC

Primary specialty

Neurology ChiropractorTaxonomy code 111NN0400X

License

CH14382 Issued in FL

Practice address

635 Court St
Clearwater, FL 33756-5512

Phone

(727) 223-9970

NPI assigned

Feb 17, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Atlas Initiative

  • Health Service Clinic/Center
  • Woodstock, GA
  • NPI 1922823863
  NPD Authorized official

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1982302006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 COURT ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337565512",
            "telephone_number": "727-223-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 COURT ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337565512",
            "telephone_number": "727-223-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KELLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "FL",
            "license": "CH14382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Alan Peter, DMD
• David O Peterfreund, M.D.
• Bruce B Peters, D.O.
• Brittany Peterson
• Julie Peterson, MS, RDN, LDN
• Mandee Peterson, CRNA
• Michael Walter Peterson, CRNA
• Julia Grace Petrarca
• Samuel Petro, O.D.
• Samantha Petroshius-Crocker, LMHC

• Neurology Chiropractor in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Neurology Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.