DR. ROBERT TODD PETERSEN (NPI# 1811917172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811917172 |
| Entity Type | Individual |
| Full Name | DR. ROBERT TODD PETERSEN |
| Credential | DC, OPAC, ATC, LAT |
| Practice Address |
3408 Milton Ave Dallas TX 75205-1338 |
| Practice Telephone | 2147392225 |
| Practice Fax Number | 2147392228 |
| Mailing Telephone | 2147392225 |
| Mailing Fax Number | 2147392228 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2014-10-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111NS0005X |
Chiropractor Specialization: Sports Physician |
5118449-1202 | UT | Chiropractic Providers |
| Y | 111NS0005X |
Chiropractor Specialization: Sports Physician |
9289 | TX | Chiropractic Providers |
| N | 363A00000X | Physician Assistant | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS ID NUMBER | 607194 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073994752 | Robert Todd Petersen | Dentist | 282 Spring Creek Pkwy Ste 202, Spring Creek, NV 89815-5822 | 2015-06-18 |
| 1356745327 | Robert Petersen | Occupational Therapy Assistant | 7105 W. 138th Ave., Cedar Lake, IN 46303 | 2014-10-20 |
| 1912296757 | Robert Lynn Petersen | Pediatrics | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2011-04-01 |
| 1437470069 | Robert Steven Petersen | Counselor | 757 S Main St, Springville, UT 84663-2452 | 2010-06-17 |
| 1578662169 | Robert Allen Petersen | Ophthalmology | 300 Longwood Ave, Boston, MA 02115-5724 | 2006-09-21 |
| 1043229685 | Robert L Petersen | Hospitalist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2006-08-05 |
| Street Address |
3408 MILTON AVE |
| City | DALLAS |
| State | TX |
| Zip Code | 75205-1338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114160827 | Park Cities Chirosport Inc | Chiropractor | 3408 Milton Ave, Dallas, TX 75205-1338 | 2009-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487298337 | Nap Diagnostics, Pllc | Electrodiagnostic Medicine | 4514 Cole Avenue Suite 600, Dallas, TX 75205 | 2019-11-04 |
| 1639578123 | Adam Martin | Specialist/Technologist, Other | 3001 Monticello, 210, Dallas, TX 75205 | 2014-08-20 |
| 1639598725 | Henry Brown Mobley | Internal Medicine | 3416 Cornell Ave., Dallas, TX 75205 | 2014-04-16 |
| 1780016857 | Heather Gano, Md, Pllc | Anesthesiology | 4447 N Central Expy Suite 110 #264, Dallas, TX 75205 | 2013-07-31 |
| 1134463961 | Dallas Emergency Dental | Dentist | 3001 Knox Ste. # 300 B, Dallas, TX 75205 | 2012-11-16 |
| 1982957270 | Ziba Tarighi Tarighi | Physician Assistant | 3414 Milton, University Park, TX 75205 | 2012-10-24 |
| 1154671113 | Bk Neuromonitoring, Pllc | Psychiatry & Neurology | 25 Highland Park Village, Suite 100 #566, Dallas, TX 75205 | 2012-09-17 |
| 1548574148 | Gd Radiology, Pa | Radiology | 5709 Hillcrest Ave. #d, Dallas, TX 75205 | 2010-08-06 |
| 1063746006 | Andrew W Randall Dds & Assoicates, PC | Dentist | 6805 Hillcrest Avenue, Suite 218, Dallas, TX 75205 | 2009-09-23 |
| 1902031875 | Dan Allen Myers | Psychiatry & Neurology | 5110 Tracy Street, Dallas, TX 75205 | 2009-05-21 |
| Find all providers in zip 75205 | ||||
| Taxonomy Code | 111NS0005X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Sports Physician |
| A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities. |
| Notes: Source: American Chiropractic Board of Sports Physicians, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811432768 | Andrew Johnson Etuk | Chiropractor | 8330 Lbj Fwy Ste 255, Dallas, TX 75243-1206 | 2017-01-02 |
| 1376860270 | Justin Anthony Fortier | Chiropractor | 6350 Lbj Fwy, Suite 166, Dallas, TX 75240-6403 | 2010-05-01 |
| 1851535553 | Anthony Jamaine Allen | Chiropractor | 6300 Samuell Blvd, Ste. 145, Dallas, TX 75228-7137 | 2009-04-24 |
| 1316065568 | Dawn Catherine Batiz | Chiropractor | 10290 Monroe Dr Ste 309, Dallas, TX 75229-5722 | 2007-03-27 |
| 1932257680 | Chirosport Inc. | Chiropractor | 2406 N Haskell Ave, Dallas, TX 75204-3708 | 2007-01-08 |
| 1427168970 | Chirosport Specialists of Dallas | Chiropractor | 4950 Belt Line Rd Ste 100, Dallas, TX 75254-6751 | 2006-08-30 |
| 1326155284 | Alexander Health Services | Chiropractor | 4801 Spring Valley Rd, Suite 40, Dallas, TX 75244 | 2006-08-24 |
| 1669480901 | Laurence N Smith | Chiropractor | 10464 E Northwest Hwy, Dallas, TX 75238-4608 | 2006-08-03 |
| 1083173173 | Patricia Colleen Ziperovich | Chiropractor | 13617 Inwood Rd Ste 210, Dallas, TX 75244-4629 | 2019-03-18 |
| 1497235790 | Viviana Hartmann | Chiropractor | 13617 Inwood Rd Ste 210, Dallas, TX 75244-4629 | 2018-08-16 |
| Find all providers in DALLAS | ||||
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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.