DR. DOUGLAS JED PETERSON (NPI# 1023142585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023142585 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS JED PETERSON |
| Credential | D.C. |
| Practice Address |
650 N State St Suite #1 Shelley ID 83274-5167 |
| Practice Telephone | 2083572225 |
| Practice Fax Number | 2083572224 |
| Mailing Telephone | 2083572225 |
| Mailing Fax Number | 2083572224 |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CHIA-855 | ID | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972071777 | Douglas Peterson | Acupuncturist | 333 E 46th St Apt 1j, New York, NY 10017-7426 | 2018-11-09 |
| 1952520710 | Douglas Don Peterson | Dentist | 2411 10th Ave N, Lake Worth, FL 33461-3128 | 2007-04-24 |
| 1770688756 | Douglas Bruce Peterson | Dentist | 8470 Us Hwy 2, Iron River, WI 54847-0400 | 2006-09-14 |
| 1437267440 | Douglas B Peterson | Internal Medicine | 1512 W 4th St, Marshfield, WI 54449-2509 | 2006-08-29 |
| 1710962832 | Douglas Peterson | Emergency Medicine | 1630 Anderson Ave, Buffalo, MN 55313-2945 | 2005-12-13 |
| 1982688388 | Douglas George Peterson | Chiropractor | 3030 Sw Moody Ave, Ste 102, Portland, OR 97201-4867 | 2005-11-30 |
| 1932399938 | Douglas Allen Peterson | Clinical Neuropsychologist | 16935 W Bernardo Dr, 238, San Diego, CA 92127-1634 | 2007-07-26 |
| 1609083856 | Douglas A Peterson | Dentist | 9 Middletown Lincroft Rd, Lincroft, NJ 07738-1511 | 2007-05-17 |
| 1174739288 | Douglas Charles Peterson | Pediatrics | 9260 Laguna Springs Dr, Suite E2-308, Elk Grove, CA 95758-7947 | 2007-05-15 |
| 1659408649 | Douglas G Peterson | Chiropractor | 1765 Taft Ave, Oshkosh, WI 54902-3220 | 2007-02-27 |
| Street Address |
650 N STATE ST SUITE #1 |
| City | SHELLEY |
| State | ID |
| Zip Code | 83274-5167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225390305 | Deidra Nichols | Physical Therapist | 650 N State St, Shelley, ID 83274-4900 | 2012-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457976045 | Tyson Hanson | Respite Care | 1496 N 1070 E, Sheley, ID 83274 | 2020-06-10 |
| 1760631949 | Curtis W Carpenter | Dentist | 295 Anderson Rd, Shelley, ID 83274 | 2008-09-12 |
| 1093908741 | Helmsman Services LLC | Community/Behavioral Health | 175 W. Pine St, Shelley, ID 83274 | 2007-08-24 |
| 1871620906 | John R Stohl | Dentist | 530 S State St, Shelley, ID 83274 | 2007-02-27 |
| 1366542391 | Blackfoot Medical Clinic, Inc | Family Medicine | 210 S Emerson St, Shelley, ID 83274 | 2006-09-22 |
| 1174775902 | Shelley Dental, Inc | Dentist | 530 S State St, Shelley, ID 83274 | 2008-10-10 |
| 1043724990 | Randall Searle | Chiropractor | 120 N Emerson Ave, Shelley, ID 83274-1105 | 2017-11-29 |
| 1215437751 | Elevated Life Family Chiropractic Pllc | Chiropractor | 120 N Emerson Ave, Shelley, ID 83274-1105 | 2018-02-20 |
| 1780784769 | Parkway Eyecare PC | Optometrist | 524 N State St, Shelley, ID 83274-1154 | 2006-09-22 |
| 1962436253 | Travis R Wilkins | Chiropractor | 528 N State St, Shelley, ID 83274-1154 | 2006-07-10 |
| Find all providers in zip 83274 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043724990 | Randall Searle | Chiropractor | 120 N Emerson Ave, Shelley, ID 83274-1105 | 2017-11-29 |
| 1093968745 | Aaron Walter Nippert | Chiropractor | 650 N State St Ste 1, Shelley, ID 83274-4900 | 2008-10-28 |
| 1962436253 | Travis R Wilkins | Chiropractor | 528 N State St, Shelley, ID 83274-1154 | 2006-07-10 |
| 1871950998 | Jordan Daniel Keck | Chiropractor | 528 N State St, Shelley, ID 83274-1154 | 2016-01-20 |
| 1316182967 | Nippert Chiropractic Health Center, P.a. | Chiropractor | 650 N State St Ste 1, Shelley, ID 83274-4900 | 2008-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124625488 | Cv Chiropractic Pllc | Chiropractor | 1201 E Gilbert Ave, Coeur D Alene, ID 83815-4958 | 2020-10-08 |
| 1780290981 | East Ridge Chiropractic, Pllc | Chiropractor | 1320 S Ammon Rd, Ammon, ID 83406-5810 | 2020-09-22 |
| 1124638143 | Madison J Wills | Chiropractor | 9196 W Emerald St Ste 120, Boise, ID 83704-8003 | 2020-08-04 |
| 1376161646 | Erena Martina Lanza | Chiropractor | 1224 1st St S Ste 304, Nampa, ID 83651-3963 | 2020-07-13 |
| 1285252619 | Kynan Tarnowski | Chiropractor | 16150 N High Desert St Ste 112, Nampa, ID 83687-5567 | 2020-07-13 |
| 1962027433 | Convergence Chiropractic Company | Chiropractor | 404 E Parkcenter Blvd Ste 170, Boise, ID 83706-7564 | 2020-06-10 |
| 1790300598 | Vancorp LLC | Chiropractor | 270 W Georgia Ave Ste 110, Nampa, ID 83686-2835 | 2020-06-08 |
| 1811519838 | Cody Wilhelm | Chiropractor | 1505 Madrona St N # 900c, Twin Falls, ID 83301-8318 | 2020-05-13 |
| 1467074559 | Amber R Dunford | Chiropractor | 3030 Glenbrook Dr, Hailey, ID 83333-7602 | 2020-05-11 |
| 1366071649 | Kevin Allen | Chiropractor | 237 N 2nd E Ste 106, Rexburg, ID 83440-4977 | 2020-04-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.