Robert Petersen, DC, OPAC, ATC, LAT
Robert Petersen, DC, OPAC, ATC, LAT is a Sports Physician Chiropractor in Dallas, TX, registered under NPI 1811917172. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 3408 MILTON AVE, Dallas, TX 75205. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 9289 | TX | Sports Physician Chiropractor primary |
| 5118449-1202 | UT | Sports Physician Chiropractor |
Licences are recorded in 2 states: TX, UT. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Chiropractic
- PAC ID
- 6406930759
- Enrollment ID
- I20080225000633
Medicare enrolment is recorded as approved under the provider type Practitioner - Chiropractic. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 2 states
This provider holds licences in 2 states: Texas and Utah. The practice address on file is in Dallas, TX, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- 9289
- Specialty
- Sports Physician Chiropractor
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Sports Physician covers
A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities. NUCC Health Care Provider Taxonomy, code 111NS0005X
All registered taxonomy codes
This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 111NS0005X | Sports Physician Chiropractor Sports Physician | 9289 | TX | primary |
| 363A00000X | Physician Assistant | — | TX | |
| 111NS0005X | Sports Physician Chiropractor Sports Physician | 5118449-1202 | UT |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1811917172 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Jul 20, 2006 |
| Last updated | Oct 30, 2014 |
| Status | Active |
| Sole proprietor | Yes |
| Credential | DC, OPAC, ATC, LAT |
| Practice address |
3408 MILTON AVE Dallas, TX 75205 (214) 739-2225 Fax (214) 739-2228 |
| Other identifiers |
607194
· Other (TX) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 8 | 1 | 1 | 9 | 1 | 7 | 1 | 7 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 8 | 2 | 1 | 9 | 1 | 5 | 1 | 5 |
Sum = 58 · next multiple of 10 = 60 · check digit = 2 · actual last digit = 2
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.