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DR. DOUGLAS JED PETERSON D.C.
NPI 1023142585
Chiropractor in Shelley, ID

Active since March 15, 2007
650 N STATE ST, SUITE #1, SHELLEY, ID 83274(208) 357-2225(208) 357-2224 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Douglas Jed Peterson D.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DOUGLAS JED PETERSON D.C. (NPI 1023142585) is an individual chiropractor in Shelley, Idaho, licensed in Idaho (CHIA-855) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1023142585
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameDR. DOUGLAS JED PETERSONCredential: D.C.
Location Address650 N STATE ST, SUITE #1Shelley, ID 83274-5167
Mailing Address650 N State St, Suite #1Shelley, ID 83274-5167 · (208) 357-2225 · Fax (208) 357-2224
Phone(208) 357-2225
Fax(208) 357-2224
Sole ProprietorYes
Enumeration DateMarch 15, 2007
Last NPPES UpdateJuly 9, 2007
✔ NPI 1023142585 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in ID · CHIA-855
Definition
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.
650 N STATE ST, Shelley, ID 83274
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Other Identifiers 2

Medicare ID-Type Unspecified1674000ID · Medicare Provider #
Medicare UPINU76079ID

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEIDRA NICHOLS DPT
Physical Therapist
650 N STATE ST
SHELLEY, ID 83274
Bingham County (208) 782-4744

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Douglas Peterson's NPI number?

The NPI number for Douglas Peterson is 1023142585. It was assigned to this individual provider in the NPPES registry on March 15, 2007.

Where is Douglas Peterson located?

Douglas Peterson practices at 650 N State St Suite #1, Shelley, ID 83274. The listed phone number is (208) 357-2225.

What is Douglas Peterson's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

When was this NPI record last updated?

The NPPES record for Douglas Peterson was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.