Individual provider Active NPI

Beverly Peters, DC

  • Chiropractor
  • Cape Girardeau, MO
National Provider Identifier
1982774840
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
006695 Issued in MO
Practice address
384 Lakota LN
Cape Girardeau, MO 63701-2739
Phone
(573) 208-0063
NPI assigned
Nov 8, 2006
Last updated
Mar 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 006695 MO Primary

Addresses

Primary practice location

384 Lakota LN
Cape Girardeau, MO 63701-2739

Mailing address

384 Lakota LN
Cape Girardeau, MO 63701-2739
Phone (573) 208-0063

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050728000003 MO Practitioner - Chiropractic 5395773741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heartland Chiropractic Center, LLCGroup PAC ID 1557646668, 2 clinicians

Practice addresses (Care Compare)

3874 E Jackson Blvd
Jackson, MO 63755-3710
Phone (573) 243-8983

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006695MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Chiropractic Center LLC Chiropractor CurrentSince Oct 10, 2023 Accepting new patients
Andrews Chiropractic & Acupuncture Center of Semo,LLC CurrentSince Oct 10, 2023 Accepting new patients
Marble Hill Medical Clinic, LLC PastSince Jul 24, 2022 Accepting new patients
Marble Hill Medical Clinic, LLC PastSince Aug 1, 2014 Accepting new patients

Locations

3874 E Jackson Blvd
Jackson, MO 63755
Phone (573) 243-8983

Organizations & group practices 4

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1982774840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "384 LAKOTA LN",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012739",
            "telephone_number": "573-208-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 LAKOTA LN",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012739",
            "telephone_number": "573-208-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "BEVERLY",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "006695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.