MR. GARY LEE PETERSON (NPI# 1629163514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629163514 |
| Entity Type | Individual |
| Full Name | MR. GARY LEE PETERSON |
| Credential | DC PA |
| Practice Address |
7100 Menaul Blvd Ne Albuquerque NM 87110-3688 |
| Practice Telephone | 5058835858 |
| Practice Fax Number | 5058830010 |
| Mailing Telephone | 5058835858 |
| Mailing Fax Number | 5058830010 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2012-04-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 317 | NM | Chiropractic Providers |
| N | 111N00000X | Chiropractor | 317 | IA | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 2671525 | 05 | |
| NM | BCBS | KC80 | 01 |
| NM | PRES | 23390 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417299074 | Gary L Peterson | Veterinarian | 1220 S State St, Salt Lake City, UT 84111-4535 | 2013-03-21 |
| 1447557616 | Gary G Peterson | Physical Therapist | 4461 Woodbridge Rd, Niceville, FL 32578-2387 | 2011-02-23 |
| 1114130465 | Gary Glen Peterson | Psychologist | 675 Sun Valley Road, C, Ketchum, ID 83340 | 2007-05-07 |
| 1518006147 | Gary S Peterson | Dentist | 123 S Stone Ave, Tucson, AZ 85701-1914 | 2007-02-06 |
| 1164589610 | Gary Robert Peterson | Counselor | 1538 The Greens Way Ste 101, Jacksonville Beach, FL 32250-1400 | 2007-01-03 |
| 1285799304 | Gary Ray Peterson | Dentist | 3815 Stephens Ave, Missoula, MT 59801-8505 | 2006-12-27 |
| 1417065566 | Gary Peterson | Psychiatry & Neurology | 103 Edwards Ridge Rd, Chapel Hill, NC 27517-9201 | 2006-08-28 |
| 1699724955 | Gary M Peterson | Family Medicine | 4702 Grand Ave, Duluth, MN 55807-2742 | 2006-05-06 |
| 1831541812 | Gary Daniel Peterson | Anesthesiology | 6000 Hospital Dr, Hannibal, MO 63401-6887 | 2016-07-01 |
| 1114384039 | Gary Peterson | Counselor | 8495 Crater Lake Hwy, White City, OR 97503-3011 | 2016-01-22 |
| Street Address |
7100 MENAUL BLVD NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87110-3688 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245747641 | Delprete Chiropractic, Inc. | Chiropractor | 7100 Menaul Blvd Ne, Albuquerque, NM 87110-3688 | 2018-01-08 |
| 1144586561 | Douglas E. Weaver D.c. | Chiropractor | 7100 Menaul Blvd Ne, Albuquerque, NM 87110-3688 | 2012-04-10 |
| 1275899601 | Scott M.delprete, D.c. | Chiropractor | 7100 Menaul Blvd Ne, Albuquerque, NM 87110-3688 | 2012-04-10 |
| 1871859249 | Gary L. Peterson D.c.pa | Chiropractor | 7100 Menaul Blvd Ne, Albuquerque, NM 87110-3688 | 2012-04-10 |
| 1609149657 | Pat Hale Dc, PC | Chiropractor | 7100 Menaul Blvd Ne, Albuquerque, NM 87110-3688 | 2012-02-21 |
| 1710203823 | Samuel J Oertel | Chiropractor | 7100 Menaul Blvd Ne, Albuquerque, NM 87110-3688 | 2010-04-14 |
| 1497929665 | Joshua Raphael Phelps | Chiropractor | 7100 Menaul Blvd Ne, Albuquerque, NM 87110-3688 | 2008-04-17 |
| 1326221417 | Chiropractic Arts | Chiropractor | 7100 Menaul Blvd Ne, Albuquerque, NM 87110-3688 | 2007-12-11 |
| 1720121502 | Scott M Delprete | Chiropractor | 7100 Menaul Blvd Ne, Albuquerque, NM 87110-3688 | 2007-02-14 |
| 1023185121 | Douglas E Weaver | Chiropractor | 7100 Menaul Blvd Ne, Albuquerque, NM 87110-3688 | 2006-11-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215550199 | Sabrina Jennifer Lujan | Counselor | 8401 Constitution Ave Nw, Albuquerque, NM 87110 | 2020-05-26 |
| 1649829318 | Robert D. Oliver | Technician | 2705 Texas Street Ne, Albuquerque, NM 87110 | 2019-09-05 |
| 1033770904 | Life Re-created LLC | Counselor | 3939 San Pedro Dr. Ne, Bld C, Ste 8, Albuquerque, NM 87110 | 2019-06-21 |
| 1497319693 | Clear Choice Vision Care, LLC | Optometrist | 6600 Menaul Blve Ne, Suite M5a, Albuquerque, NM 87110 | 2019-04-24 |
| 1790257558 | Diana M Nicolas | Dietitian, Registered | 8300 Constitution Ave Ne Bld D, Albuquerque, NM 87110 | 2018-12-18 |
| 1689168403 | Robin N Hermes, Md, PC | Anesthesiology | 2440 Lousiana Blvd. Ne, Ste 580, Albuquerque, NM 87110 | 2018-06-15 |
| 1710481726 | Desert Mountain Eyecare LLC | Optometrist | 5504 Menaul Blvd Ne Ste Aandb, Albuquerque, NM 87110 | 2018-03-23 |
| 1659873131 | Amanda Lacasse | Registered Nurse | 6400 Uptown Blvd Ne Suite 360 West, Albuquerque, NM 87110 | 2018-03-01 |
| 1518485655 | Danielle Liegh Wyne | Counselor | 6121 Indian School Rd, Suite 141, Albuquerque, NM 87110 | 2017-09-08 |
| 1265957237 | Myrrhine Faller | Speech-Language Pathologist | 6020 Constitution Ave. Ne, Suite 4, Albuquerque, NM 87110 | 2017-08-10 |
| Find all providers in zip 87110 | ||||
| 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 |
|---|---|---|---|---|
| 1689295834 | Kevin Chick | Chiropractor | 2800 San Mateo Blvd Ne Ste 109, Albuquerque, NM 87110-3166 | 2020-04-29 |
| 1457994311 | Stella Aubert | Chiropractor | 2800 San Mateo Blvd Ne Ste 105, Albuquerque, NM 87110-3166 | 2019-10-23 |
| 1821630427 | Taylor Lee Eaves | Chiropractor | 7520 Montgomery Blvd Ne Bldg E, Albuquerque, NM 87109-1521 | 2019-10-15 |
| 1003463878 | Alexander David Johnson | Chiropractor | 5308 Delvitto Ct Ne, Albuquerque, NM 87111-1648 | 2019-08-26 |
| 1477028678 | Melanie Beach | Chiropractor | 8001 Wyoming Blvd Ne Ste D4, Albuquerque, NM 87113-2013 | 2018-10-04 |
| 1346768363 | Edwards Chiropractic and Natural Health Center | Chiropractor | 5300 Sequoia Rd Nw Ste 200, Albuquerque, NM 87120-1248 | 2017-08-30 |
| 1043734403 | Backbone Family Chiropractic | Chiropractor | 2901 Juan Tabo Blvd Ne Ste 121b, Albuquerque, NM 87112-1869 | 2017-07-27 |
| 1801345897 | Jacqueline Carlisle | Chiropractor | 5901 Wyoming Blvd Ne Ste V, Albuquerque, NM 87109-3859 | 2016-10-02 |
| 1164879318 | Travis Lee Mason | Chiropractor | 6308 Mesquite Dr Nw, Albuquerque, NM 87120 | 2016-05-18 |
| 1083087472 | Shaylyn Weber | Chiropractor | 2621 Coors Blvd Nw Ste D, Albuquerque, NM 87120-1729 | 2015-11-06 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87110 |
Please comment or provide details below to improve the information on MR. GARY LEE PETERSON.
| 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.