DR. MATTHEW WADE PETERSON D.C. NPI 1326011891

NPI Information

NPI: 1326011891
Provider Name: DR. MATTHEW WADE PETERSON, D.C.
Classification: Chiropractor - 111N00000X
Entity Type: Individual
Address:
10456 S REDWOOD RD
SOUTH JORDAN, UT
ZIP 84095
Phone: (801) 878-9565
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DR. Matthew Wade Peterson, D.C. is a chiropractor in South Jordan, UT. 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. Matthew Wade Peterson, D.C. NPI is 1326011891. 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:

10456 S REDWOOD RD
SOUTH JORDAN, UT
ZIP 84095-501
Phone: (801) 878-9565
Fax: (801) 432-8072

The enumeration date for this NPI number is 2/7/2006 and was last updated on 11/19/2012.

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
1	111N00000X	Chiropractor		370378-1202	UTAH	Yes

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
1	870395551005	MEDICAID	UTAH
2	000056279	MEDICARE ID-TYPE UNSPECIFIED	UTAH
3	U82234	MEDICARE UPIN	UTAH

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

NPI Synchronization or Removal

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