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DR. SHANNON PETERSON DC NPI 1316975683


NPI Information

NPI: 1316975683
Provider Name: DR. SHANNON PETERSON, DC
Classification: Chiropractor - 111N00000X
Entity Type: Individual
Address:
N275 MILITARY RD
SUITE 2
SHERWOOD, WI
ZIP 54169
Phone: (920) 989-1599
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DR. Shannon Peterson, DC is a chiropractor in Sherwood, WI with 23 years of experience. 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. Shannon Peterson, DC NPI is 1316975683. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: PALMER COLLEGE CHIROPRACTIC - DAVENPORT
Graduation Year:2001

The provider's business location address is:

N275 MILITARY RD
SUITE 2
SHERWOOD, WI
ZIP 54169-603
Phone: (920) 989-1599
Fax: (920) 989-1593

The enumeration date for this NPI number is 6/28/2006 and was last updated on 7/8/2007.


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
1111N00000XChiropractor3809-012WISCONSINYes

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
1U88756MEDICARE UPINWISCONSIN
2000075593-0001MEDICARE ID-TYPE UNSPECIFIEDWISCONSIN
338937000MEDICAIDWISCONSIN

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.