JONATHAN PETERSON (NPI# 1003882010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003882010 |
| Entity Type | Individual |
| Full Name | JONATHAN PETERSON |
| Credential | M.D. |
| Practice Address |
1200 Grant Blvd W Wabasha MN 55981-1042 |
| Practice Telephone | 6515655908 |
| Practice Fax Number | 6515655910 |
| Mailing Telephone | 6515655908 |
| Mailing Fax Number | 6515655910 |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
33320 | MN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093948614 | Jonathan Ryan Peterson | Dentist | 800 W Chandler Blvd Ste 1, Chandler, AZ 85225-2508 | 2009-08-30 |
| 1013129857 | Jonathan J Peterson | Chiropractor | 3076 E. Chandler Heights Rd., Suite 107, Gilbert, AZ 85298 | 2007-05-04 |
| 1659450005 | Jonathan Bernt Peterson | Family Medicine | 8500 W Colfax Ave, Lakewood, CO 80215-4011 | 2006-11-06 |
| 1124641071 | Jonathan Peterson | Student in an Organized Health Care Education/Training Program | 200 Lothrop St, Pittsburgh, PA 15213-2536 | 2020-05-27 |
| 1609360247 | Jonathan C Peterson | Behavior Technician | 9500 Annapolis Rd Ste B2, Lanham, MD 20706-2062 | 2018-06-18 |
| 1457705386 | Jonathan Richard Peterson | Orthopaedic Surgery | 2301 Erwin Rd, Durham, NC 27710 | 2016-04-18 |
| 1245491182 | Jonathan Bradley Peterson | Orthopaedic Surgery | 1836 South Ave, La Crosse, WI 54601 | 2008-06-23 |
| 1053535930 | Jonathan Paul Peterson | Pediatrics | 15 S 1000 E, Suite 200, Payson, UT 84651-5590 | 2007-04-12 |
| Street Address |
1200 GRANT BLVD W |
| City | WABASHA |
| State | MN |
| Zip Code | 55981-1042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659355600 | Saint Elizabeths Hospital of Wabasha Inc | Clinical Medical Laboratory | 1200 Grant Blvd W, Wabasha, MN 55981-1098 | 2005-12-02 |
| 1851858112 | Paula Kae Thompson | Dietitian, Registered | 1200 Grant Blvd W, Wabasha, MN 55981-1042 | 2019-02-22 |
| 1245727056 | Malinda Jean Wise | Social Worker | 1200 Grant Blvd W, Wabasha, MN 55981 | 2018-04-17 |
| 1376047431 | Brady Ritscher | Pharmacist | 1200 Grant Blvd W, Wabasha, MN 55981-1042 | 2018-03-22 |
| 1477068914 | Saint Elizabeths Hospital of Wabasha Inc | Clinic/Center | 1200 Grant Blvd W, Wabasha, MN 55981-1042 | 2017-12-06 |
| 1851819163 | Carol Ann Groth | Occupational Therapy Assistant | 1200 Grant Blvd W, Wabasha, MN 55981-1042 | 2017-09-07 |
| 1073050274 | Saint Elizabeths Hospital of Wabasha Inc | Clinic/Center | 1200 Grant Blvd W, Wabasha, MN 55981-1042 | 2017-01-25 |
| 1164977880 | Elizabeth Nofsinger | Physical Therapist | 1200 Grant Blvd W, Wabasha, MN 55981-1042 | 2016-08-23 |
| 1053785840 | Matthew Wagner | Registered Nurse | 1200 Grant Blvd W, Wabasha, MN 55981 | 2015-11-17 |
| 1518339415 | Ryan Randy Reidt | Physical Therapist | 1200 Grant Blvd W, Wabasha, MN 55981-1042 | 2015-10-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396266003 | Lc Edelbach Company LLC | Pharmacy | 160 Main Street West, Wabasha, MN 55981 | 2017-07-03 |
| 1154372217 | Robert James Mann | Dentist | 115 E Main Street, Wabasha, MN 55981 | 2006-05-13 |
| 1447772249 | Katlyn Jo Jessen | Counselor | 611 Broadway Ave Ste 100, Wabasha, MN 55981 | 2017-07-13 |
| 1760783492 | Anna Emily Battcher | Pharmacist | 1200 5th Grant Blvd, Wabasha, MN 55981-1042 | 2010-11-11 |
| 1679636393 | Ursula I Miller | Family Medicine | 1202 Grant Blvd W, Wabasha, MN 55981-1042 | 2006-12-18 |
| 1437139730 | Marc J. Hampl | Physician Assistant | 1202 5th Grant Blvd, Wabasha, MN 55981-1042 | 2006-01-20 |
| 1184720567 | Fred Mcrae Roberson | Family Medicine | 1202 5th Grant Blvd, Lake City Medical Center, Wabasha, MN 55981-1042 | 2006-09-15 |
| 1316980907 | Mark Wayne Bingham | Physician Assistant | 1202 5th Grant Blvd, Wabasha, MN 55981-1042 | 2006-06-13 |
| 1558331090 | Valerie D. Mcgrath | Physician Assistant | 1202 5th Grant Blvd, Wabasha, MN 55981-1042 | 2006-01-26 |
| 1659341212 | Brian E. Kelly | Family Medicine | 1202 5th Grant Blvd, Wabasha, MN 55981-1042 | 2006-01-25 |
| Find all providers in zip 55981 | ||||
| Taxonomy Code | 2084P0805X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Geriatric Psychiatry |
| Geriatric Psychiatry is a subspecialty with psychiatric expertise in prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly, and improvement of psychiatric care for healthy and ill elderly patients. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548680259 | Laura Pientka | Psychiatry & Neurology | 1 Veterans Dr # 116a, Minneapolis, MN 55417-2309 | 2014-04-21 |
| 1679802797 | William B Orr Consulting Pa | Psychiatry & Neurology | 720 Main St Ste 204, Mendota Hts, MN 55118-1800 | 2009-12-19 |
| 1477757607 | Paulo R Shiroma | Psychiatry & Neurology | 200 1st St Sw, Rochester, MN 55905-0001 | 2007-06-12 |
| 1871665711 | William A Callahan | Psychiatry & Neurology | 6525 Drew Ave S, Edina, MN 55435 | 2006-11-15 |
| 1558457390 | Susan Elizabeth Czapiewski | Psychiatry & Neurology | 1 Veterans Dr, 116a, Minneapolis, MN 55417-2309 | 2006-10-05 |
| 1114020641 | Geriatric & General Psychiatry | Psychiatry & Neurology | 6525 Drew Ave S, Edina, MN 55435 | 2006-09-07 |
| 1831203017 | Maurice William Dysken | Psychiatry & Neurology | 1 Veterans Dr, Minneapolis, MN 55417-2309 | 2006-08-18 |
| 1639121700 | Kathryn D Lombardo | Psychiatry & Neurology | 210 9th St Se, Rochester, MN 55904-6425 | 2006-05-17 |
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| 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.