DR. GLEN ALLEN PETERSON D.C. NPI 1063444776

NPI Information

  • NPI: 1063444776
  • Provider Name: DR. GLEN ALLEN PETERSON, D.C.
  • Classification: Chiropractor - 111N00000X
  • Entity Type: Individual
  • Address: 817 N SMITHFIELD RD
    KNIGHTDALE, NC
    ZIP 27545
  • Phone: (919) 217-8188

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NPI Details

DR. Glen Allen Peterson, D.C. is a chiropractor in Knightdale, NC. The provider is 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. DR. Glen Allen Peterson, D.C. NPI is 1063444776. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

817 N SMITHFIELD RD
KNIGHTDALE, NC
ZIP 27545-717
Phone: (919) 217-8188
Fax: (919) 217-8189

The enumeration date for this NPI number is 7/6/2006 and was last updated on 11/14/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractor3728NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15907457MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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