JEROME R PETERSON (NPI# 1336114966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336114966 |
| Entity Type | Individual |
| Full Name | JEROME R PETERSON |
| Credential | MD |
| Practice Address |
8450 Seasons Pkwy Woodbury MN 55125-4402 |
| Mailing Address |
8100 34th Ave S Mail Stop 33100a Bloomington MN 55425-1672 |
| Practice Telephone | 6123393663 |
| Practice Fax Number | 6517025305 |
| Mailing Telephone | 9528835463 |
| Mailing Fax Number | 9528835395 |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 19789 | MN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134393366 | Jerome N. Peterson | Dentist | 3620 S Bristol St Ste 302, Santa Ana, CA 92704-7316 | 2008-04-18 |
| Street Address |
8450 SEASONS PKWY |
| City | WOODBURY |
| State | MN |
| Zip Code | 55125-4402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316922065 | Jeffrey Lloyd Sikkink | Family Medicine | 8450 Seasons Pkwy, Woodbury, MN 55125 | 2005-12-14 |
| 1184106726 | Dana Cizinski | Dietitian, Registered | 8450 Seasons Pkwy, Woodbury, MN 55125-4402 | 2018-08-30 |
| 1346761087 | Karen Villarente Barcelon | Nurse Practitioner | 8450 Seasons Pkwy, Woodbury, MN 55125-4402 | 2017-07-03 |
| 1093249013 | Marlen Midthune | Family Medicine | 8450 Seasons Pkwy, Woodbury, MN 55125-4402 | 2017-04-17 |
| 1235661661 | Erin Catherine Boland | Nurse Practitioner | 8450 Seasons Pkwy, Woodbury, MN 55125-4402 | 2017-04-03 |
| 1710429303 | Jacob Clairmont | Physician Assistant | 8450 Seasons Pkwy, Woodbury, MN 55125-4402 | 2016-11-14 |
| 1063968394 | Robin Shultz | Physician Assistant | 8450 Seasons Pkwy, Woodbury, MN 55125-4402 | 2016-08-28 |
| 1154776854 | Bisrat Fekadu | Family Medicine | 8450 Seasons Pkwy, Woodbury, MN 55125-4402 | 2016-05-01 |
| 1063866762 | Chelsey Prall | Pediatrics | 8450 Seasons Pkwy, Woodbury, MN 55125-4402 | 2016-04-19 |
| 1295196285 | Nikki L Marcellino | Physician Assistant | 8450 Seasons Pkwy, Woodbury, MN 55125-4402 | 2016-03-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487268728 | Haley Kirkpatrick | Behavior Technician | 721 Commerce Dr., Woodbury, MN 55125 | 2020-09-03 |
| 1689218091 | Jordan Schmidt | Student in an Organized Health Care Education/Training Program | 1740 Welr Dr. #24, Woodbury, MN 55125 | 2019-10-30 |
| 1629619580 | Mackenzie Ann Funke | Occupational Therapist | 721 Commerce Drivve, Woodbury, MN 55125 | 2019-10-02 |
| 1700342029 | Darcy Stivland | Counselor | 1811 Weir Drive #270, Woodbury, MN 55125 | 2019-02-11 |
| 1235609884 | Elizabeth Kennedy Ward | Psychologist | 7582 Currell Blvd Suite 208, Woodbury, MN 55125 | 2018-11-27 |
| 1528573664 | Cory Lee Baumeister | Counselor | 652 Bielenberg Dr, Woodbury, MN 55125 | 2017-12-12 |
| 1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
| 1366988826 | Mark Your Home Health Care LLC | Home Health | 6053 Hudson Road, Suite 200, Woodbury, MN 55125 | 2017-01-09 |
| 1518415736 | Kubei Holdings Group LLC | Case Management | 6043 Hudson Rd Ste 340, Saint Paul, MN 55125 | 2016-09-16 |
| 1285087072 | Adrian Jung | Occupational Therapist | 155 Radio Drive, Woodbury, MN 55125 | 2016-07-18 |
| Find all providers in zip 55125 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912242520 | Pjacoby, LLC | Emergency Medicine | 167 Sprain Brook Rd, Woodbury, CT 06798-1914 | 2012-12-07 |
| 1326353913 | Michael John Garcia Jr. | Emergency Medicine | 344 S Jackson St, Woodbury, NJ 08096-2625 | 2010-08-09 |
| 1417196544 | Todd Marker Warden | Emergency Medicine | 549 Delaware St., Woodbury, NJ 08096 | 2009-02-12 |
| 1235329988 | Charles Everett Nicholson, Jr. | Emergency Medicine | 115 Rugby Place, Woodbury, NJ 08096-0400 | 2007-07-30 |
| 1669545638 | Oreste Joseph Bruni | Emergency Medicine | 397 Woodbury Rd, Woodbury, NY 11797-1201 | 2006-11-16 |
| 1104998517 | Herbert Butler | Emergency Medicine | 157 Rugby Pl, Woodbury, NJ 08096-1805 | 2006-11-14 |
| 1538244421 | William Richard Schmidt | Emergency Medicine | 183 Washington Rd, Woodbury, CT 06798-2806 | 2006-10-26 |
| 1083663769 | Joseph Louis Granito | Emergency Medicine | 630 Mantua Pike, Woodbury, NJ 08096-3233 | 2006-05-09 |
| 1477518298 | Jordan Biet Barnett | Emergency Medicine | 307 S Evergreen Ave, Woodbury, NJ 08096-2739 | 2006-04-18 |
| 1922480912 | Sambita Basu Bellman | Emergency Medicine | 307 S Evergreen Ave, Woodbury, NJ 08096-2739 | 2015-06-25 |
| Find all providers in WOODBURY | ||||
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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.