SCOTT M PETERSON (NPI# 1053303123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053303123 |
| Entity Type | Individual |
| Full Name | SCOTT M PETERSON |
| Credential | CRNA |
| Practice Address |
8990 Springbrook Dr Nw Ste 250 Coon Rapids MN 55433-5850 |
| Mailing Address |
13330 Greenwich Ct Apple Valley MN 55124-7620 |
| Practice Telephone | 7633980099 |
| Practice Fax Number | 7633980124 |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2008-05-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | R 121227-9 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 491525900 | 05 | |
| MN | BCBSMN | 507R4PE | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801436787 | Scott Kermit Peterson | Registered Nurse | 30681 Olson St Apt 2, Pequot Lakes, MN 56472-3081 | 2020-01-08 |
| 1619413093 | Scott T Peterson | Dentist | 5235 W Baseline Rd, #187, Laveen, AZ 85339-3122 | 2017-01-10 |
| 1427202266 | Scott Andrew Peterson | Social Worker | 2000 Dry Valley Road, Loa, UT 84747 | 2008-11-06 |
| 1336398783 | Scott Allen Peterson | Occupational Therapist | 8765 Blue Pine Way, Reno, NV 89523-3843 | 2008-09-10 |
| 1013034842 | Scott L. Peterson | Counselor | 11011 S 48th St Ste 200, Phoenix, AZ 85044-1788 | 2007-03-25 |
| 1033126974 | Scott Michael Peterson | Specialist/Technologist | Lemoyne College Sports Medicine, 1419 Salt Springs Road, Syracuse, NY 13214-1399 | 2006-08-02 |
| 1750351441 | Scott David Peterson | Optometrist | 3988 Washington Blvd, Ogden, UT 84403-1826 | 2006-01-25 |
| 1649250242 | Scott M Peterson | Obstetrics & Gynecology | 3300 W Centre Ave, Bronson Ob Gyn Associates, Portage, MI 49024-4666 | 2006-01-19 |
| 1457917627 | Scott Jeffrey Peterson | Social Worker | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2019-05-14 |
| 1598121808 | Scott Peterson | Ophthalmology | 3777 Coon Rapids Blvd Nw Ste 100, Coon Rapids, MN 55433-2630 | 2016-01-04 |
| Street Address |
8990 SPRINGBROOK DR NW STE 250 |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-5850 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992706147 | Monica S Lucus | Nurse Anesthetist, Certified Registered | 8990 Springbrook Dr Nw, Suite 250, Coon Rapids, MN 55433-5850 | 2005-08-09 |
| 1437554334 | Rebecca Weaver | Nurse Anesthetist, Certified Registered | 8990 Springbrook Dr Nw, #250, Coon Rapids, MN 55433-5850 | 2014-11-04 |
| 1336490929 | Carly Felicetta | Nurse Anesthetist, Certified Registered | 8990 Springbrook Dr Nw, #250, Coon Rapids, MN 55433 | 2012-09-24 |
| 1306194717 | Amy Josephine Henderson | Registered Nurse | 8990 Springbrook Dr Nw, Suite 250, Coon Rapids, MN 55433-5850 | 2012-08-16 |
| 1013275502 | Mark Retz | Nurse Anesthetist, Certified Registered | 8990 Springbrook Dr Nw, Suite 250, Coon Rapids, MN 55433-5850 | 2012-05-02 |
| 1184992489 | Amanda Ihry | Nurse Anesthetist, Certified Registered | 8990 Springbrook Dr Nw, Suite 250, Coon Rapids, MN 55433-5850 | 2011-12-01 |
| 1518263797 | Megan Lynn Kakela | Nurse Anesthetist, Certified Registered | 8990 Springbrook Dr Nw, Suite 250, Coon Rapids, MN 55433-5850 | 2011-02-04 |
| 1548417645 | Jeremy Vazquez-kessel | Nurse Anesthetist, Certified Registered | 8990 Springbrook Dr Nw, Suite 250, Coon Rapids, MN 55433-5850 | 2008-08-20 |
| 1144477241 | Beth Ellen Johnson | Nurse Anesthetist, Certified Registered | 8990 Springbrook Dr Nw, Suite 250, Coon Rapids, MN 55433-5850 | 2008-08-20 |
| 1992973358 | Behavioral Therapy Center, Inc. | Clinic/Center | 8990 Springbrook Dr Nw, Suite 220, Coon Rapids, MN 55433-5850 | 2008-02-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790073153 | Summer Ann Burlingame | Nurse Anesthetist, Certified Registered | 8990 Springbrook Dr Nw Ste 250, Coon Rapids, MN 55433-5884 | 2011-07-19 |
| 1740581594 | Amanda Naomi Ryan | Nurse Anesthetist, Certified Registered | 8990 Springbrook Dr. Nw, Suite 250, Coon Rapids, MN 55433-5884 | 2010-11-10 |
| 1326010992 | Adelle Daigle-bjerke | Nurse Anesthetist, Certified Registered | 199 Coon Rapids Blvd Nw, Suite 113, Coon Rapids, MN 55433-5831 | 2006-02-07 |
| 1992706147 | Monica S Lucus | Nurse Anesthetist, Certified Registered | 8990 Springbrook Dr Nw, Suite 250, Coon Rapids, MN 55433-5850 | 2005-08-09 |
| 1033756655 | Jeffrey Alan Leech II | Nurse Anesthetist, Certified Registered | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 | 2019-12-02 |
| 1154781342 | Ashley M Hansmann | Nurse Anesthetist, Certified Registered | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 | 2016-03-01 |
| 1780044024 | Shaun S Dowd | Nurse Anesthetist, Certified Registered | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 | 2016-02-29 |
| 1598158784 | Lisa Niemczyk Glogowski | Nurse Anesthetist, Certified Registered | 8990 Springbrook Dr Nw Ste 250, Coon Rapids, MN 55433 | 2015-03-11 |
| 1437554334 | Rebecca Weaver | Nurse Anesthetist, Certified Registered | 8990 Springbrook Dr Nw, #250, Coon Rapids, MN 55433-5850 | 2014-11-04 |
| 1336490929 | Carly Felicetta | Nurse Anesthetist, Certified Registered | 8990 Springbrook Dr Nw, #250, Coon Rapids, MN 55433 | 2012-09-24 |
| Find all providers in COON RAPIDS | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
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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.