DR. PAUL H PETERSON (NPI# 1083902126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083902126 |
| Entity Type | Individual |
| Full Name | DR. PAUL H PETERSON |
| Credential | DPM |
| Practice Address |
1420 109th Ave Ne Ste 100 Blaine MN 55449-3603 |
| Practice Telephone | 7635815880 |
| Practice Fax Number | 7635815551 |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2014-12-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 912 | MN | Podiatric Medicine & Surgery Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134769979 | Paul Peterson | Non-emergency Medical Transport (VAN) | 4314 45th St N, Fargo, ND 58102-6915 | 2020-01-09 |
| 1013304500 | Paul Carlton Peterson | Home Health Aide | 712 4th St Ne, Washington, DC 20002-4316 | 2015-04-22 |
| 1245498971 | Paul Stephen Peterson | Physician Assistant | 5731 Silverstone Ter Ste 100, Colorado Springs, CO 80919-3594 | 2008-05-29 |
| 1285752642 | Paul Arthur Peterson | Specialist/Technologist | 46400 Algonkian Pkwy, Potomac Falls, VA 20165-6487 | 2007-03-26 |
| 1528114667 | Paul Joseph Peterson | Social Worker | 1459 N Main St Ste 100, Bountiful, UT 84010-6092 | 2007-01-25 |
| 1194876672 | Paul Gabriel Peterson | Student in an Organized Health Care Education/Training Program | Wramc Department of Radiology, 6900 Georgia Ave. Nw, Bldg. 2, Washington, DC 20307-0001 | 2007-01-13 |
| 1972678993 | Paul Stanley Peterson | Chiropractor | 4616 El Camino Ave, Sacramento, CA 95821-6736 | 2006-11-22 |
| 1275646465 | Paul J Peterson | Social Worker | 102 Southend Dr, Dayton, NV 89403-7414 | 2006-08-15 |
| 1326013426 | Paul D Peterson | Family Medicine | 2600 Outer Dr N, Sioux City, IA 51104-1585 | 2006-02-22 |
| 1861494486 | Paul D Peterson | Internal Medicine | 2207 S Clear Creek Rd, Ste 304, Killeen, TX 76549-4132 | 2005-08-12 |
| Street Address |
1420 109TH AVE NE STE 100 |
| City | BLAINE |
| State | MN |
| Zip Code | 55449-3603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033736368 | Landon Thomas Case | Dentist | 10729 Town Square Drive Ne, Ste 100, Blaine, MN 55449 | 2020-07-02 |
| 1881168441 | Ear Institutes, LLC | Otolaryngology | 4365 Pleasant Ridge Dr Ne, Suite 106, Blaine, MN 55449 | 2019-01-17 |
| 1841776242 | Kristin Broback | Nurse Practitioner | 10705 Town Square Dr Ne #100, Blaine, MN 55449 | 2018-07-18 |
| 1043719016 | Robin Lynn Broen | Registered Nurse | 3012 129th Ave Ne, Blaine, MN 55449 | 2018-02-06 |
| 1194197368 | Lund Health Professional Corporation | Chiropractor | 1360 101st Ave Ne, Suite 140, Blaine, MN 55449 | 2015-10-27 |
| 1871989806 | Blaine Wp II, LLC | Assisted Living Facility | 12402 Jamestown Street Ne, Blaine, MN 55449 | 2015-04-07 |
| 1154761633 | Jean Budge | Marriage & Family Therapist | 11800 Aberdeen Street Ne, Suite 100, Blaine, MN 55449 | 2013-06-28 |
| 1295013498 | Jeff K Yu | Veterinarian | 11850 Aberdeen St Ne, Blaine, MN 55449 | 2011-07-22 |
| 1528394707 | Julie Ann Eibensteiner | Physical Therapist | 11304 Davenport Circle Ne #a, Minneapolis, MN 55449 | 2009-10-23 |
| 1871725333 | Deborah Kathryn Zongo | Nurse Practitioner | 10190 Baltimore St Ne Ste 100, Blaine, MN 55449 | 2009-08-18 |
| Find all providers in zip 55449 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912556937 | Seniorwell Pod of Minnesota, LLC | Podiatrist | 100 S 5th St Ste 1900, Minneapolis, MN 55402-1267 | 2019-09-11 |
| 1033553789 | Advanced Foot & Ankle Clinic LLP | Podiatrist | 633 1st St Se Ste 100, Faribault, MN 55021-6348 | 2013-04-24 |
| 1881963239 | Foot Care Across America, LLC | Podiatrist | 14654 Rhinestone Terrace, Ramsey, MN 55303-4923 | 2011-12-14 |
| 1619261708 | Nathan D Sanders | Podiatrist | 404 West Fountain Street, Albert Lea, MN 56007-3920 | 2011-06-06 |
| 1427352087 | Doctors By Your Side | Podiatrist | 6600 Lyndale Av S, #120, Richfield, MN 55423-3398 | 2010-12-22 |
| 1154566396 | Sarah Phelps Whittaker | Podiatrist | 2221 Ford Parkway, Suite #350, Saint Paul, MN 55116-3837 | 2008-12-02 |
| 1568635969 | Bolcer Podiatry, Inc. | Podiatrist | 19230 Evans St Nw Ste 109, Elk River, MN 55330-1079 | 2008-04-07 |
| 1194846782 | Range Podiatric Care, Pa | Podiatrist | 809 N 6th Ave, Northgate Plaza, Virginia, MN 55792-2308 | 2007-04-02 |
| 1285779991 | John Tyler Garner | Podiatrist | 2302 Highway 53, Eveleth, MN 55734-8523 | 2007-02-20 |
| 1659422509 | Summit Orthopedics, Ltd. | Podiatrist | 7115 Tamarack Rd Ste 250, Woodbury, MN 55125-1209 | 2007-01-16 |
| Find all providers with the same taxonomy | ||||
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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.