DR. GLEN ALLEN PETERSON (NPI# 1063444776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063444776 |
| Entity Type | Individual |
| Full Name | DR. GLEN ALLEN PETERSON |
| Credential | D.C. |
| Practice Address |
817 N Smithfield Rd Knightdale NC 27545-7717 |
| Practice Telephone | 9192178188 |
| Practice Fax Number | 9192178189 |
| Mailing Telephone | 9192178188 |
| Mailing Fax Number | 9192178189 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2014-11-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 3728 | NC | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5907457 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437209418 | Glen R Peterson | Chiropractor | 501 1st St, La Salle, IL 61301-2416 | 2007-01-11 |
| 1508956186 | Glen Peterson | Nurse Practitioner | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2006-10-13 |
| 1922196690 | Glen Francis Peterson | Dentist | 8721 Wadsworth Blvd, Suite #b, Arvada, CO 80003-0929 | 2006-10-10 |
| Street Address |
817 N SMITHFIELD RD |
| City | KNIGHTDALE |
| State | NC |
| Zip Code | 27545-7717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639688526 | Galberth Health | Physical Therapist | 8002 Peachtree Town Ln, Knightdale, NC 27545 | 2017-09-24 |
| 1790215390 | Edward Hoggard Jr. | Counselor | 2013 Ballston Place, Knightdale, NC 27545 | 2017-06-15 |
| 1730635970 | Tara Forsythe | Social Worker | 4006 Peachtree Town Lane, Knightdale, NC 27545 | 2016-08-28 |
| 1134504962 | Maybell Grino | Pharmacist | 7201 Us Highway 64, Knightdale, NC 27545 | 2015-07-22 |
| 1477948735 | Q1 Clinical Consultants, LLC | Community/Behavioral Health | 1408 Silver Valley Dr, Knightdale, NC 27545 | 2015-04-03 |
| 1235560772 | Shameka Latoya Davis | Counselor | 7417 Knightdale Blvd Unit 101, Knightdale, NC 27545 | 2013-12-10 |
| 1992135107 | Daniel Ross Conti | Dentist | 1001 Widewaters Parkway, Knightdale, NC 27545 | 2013-11-25 |
| 1255773644 | David D Sanjurjo | Nurse Practitioner | 7201 Us Hwy 64, Knightdale, NC 27545 | 2013-07-25 |
| 1790037133 | Dona D Mayo | Counselor | 502 Mcknight Drive, Better Communities, Knightdale, NC 27545 | 2012-10-09 |
| 1699972257 | Lindsay Horwat | Occupational Therapist | 1010 Emerald Common Drive, Apartment 205, Knightdale, NC 27545 | 2007-06-28 |
| Find all providers in zip 27545 | ||||
| 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 |
|---|---|---|---|---|
| 1730650045 | Samuel Feinberg | Chiropractor | 4001 Widewaters Pkwy Ste A, Knightdale, NC 27545-7315 | 2018-12-13 |
| 1821277021 | Wake Spine and Disc Inc | Chiropractor | 1008a Big Oak Ct, Knightdale, NC 27545-8841 | 2007-10-24 |
| 1649336736 | Christopher Cole Bradburn | Chiropractor | 4025 Village Park Dr, Knightdale, NC 27545-7044 | 2006-12-31 |
| 1275626764 | Floyd Samuel Critoria | Chiropractor | 1008 A Big Oak Ct, Knightdale, NC 27545-8841 | 2006-10-02 |
| 1205831989 | Jason N Kucma | Chiropractor | 4023 Village Park Dr, Knightdale, NC 27545-7044 | 2005-06-17 |
| 1780096131 | Adam Luke Beck | Chiropractor | 6905 Knightdale Blvd Ste 105, Knightdale, NC 27545-6506 | 2014-05-20 |
| 1013186493 | Trinity Chiropractic Wellness, Pllc | Chiropractor | 4025 Village Park Dr, Knightdale, NC 27545-7044 | 2008-02-29 |
| 1689792004 | Lisa K Kucma | Chiropractor | 4023 Village Park Dr, Knightdale, NC 27545-7044 | 2007-03-26 |
| 1245391366 | Camelot Chiropractic Centre, Inc. | Chiropractor | 4023 Village Park Dr, Knightdale, NC 27545-7044 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001776 | Abigail Plowcha | Chiropractor | 4818 Charlton Ln, Charlotte, NC 28210-2705 | 2020-10-22 |
| 1154920056 | Willow Health and Wellness | Chiropractor | 643 Greenway Rd Ste K1, Boone, NC 28607-4840 | 2020-10-21 |
| 1639778855 | Brittany Alexa Kopec | Chiropractor | 916 W Morgan St, Raleigh, NC 27603-1512 | 2020-10-19 |
| 1598363343 | Sierra Davis | Chiropractor | 8420 New Town Rd Ste 102, Waxhaw, NC 28173-7088 | 2020-10-14 |
| 1225644024 | Tory Hall | Chiropractor | 8424 Ovation Dr, Cary, NC 27513-2646 | 2020-09-17 |
| 1821602707 | Jose Cruz Troche | Chiropractor | 6253 South Blvd, Charlotte, NC 28217-4440 | 2020-09-08 |
| 1720692924 | Scott Chiropractic LLC | Chiropractor | 1075 Walmart Dr, Williamston, NC 27892-9749 | 2020-09-04 |
| 1437763711 | Robert Cameron Browney | Chiropractor | 41 N Merrimon Ave Unit 111, Woodfin, NC 28804-1364 | 2020-09-03 |
| 1467066076 | Christopher Mckechnie | Chiropractor | 827 Heart Wood Loop Rd Ne, Leland, NC 28451-9419 | 2020-09-01 |
| 1548873706 | Hunter Samuel Buckley | Chiropractor | 8928 Us 70 Bus Hwy W Ste 700, Clayton, NC 27520-4847 | 2020-08-27 |
| Find all providers with the same taxonomy | ||||
| City | KNIGHTDALE |
| Zip Code | 27545 |
Please comment or provide details below to improve the information on DR. GLEN ALLEN 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.