KEVIN P PETERSON (NPI# 1558327064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558327064 |
| Entity Type | Individual |
| Full Name | KEVIN P PETERSON |
| Credential | MD |
| Practice Address |
1414 Maryland Ave E Umphysicians Phalen Village Clinic Minneapolis MN 55106 |
| Mailing Address |
720 Washington Ave Se, Ste 200 University of Minnesota Physicians Minneapolis MN 55414 |
| Practice Telephone | 6517723461 |
| Practice Fax Number | 6517725477 |
| Mailing Telephone | 6128840649 |
| Mailing Fax Number | 6126768992 |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2013-02-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 27012 | MN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407499957 | Kevin Michael Peterson | Dentist | 1607 Westgate Cir Ste 400, Brentwood, TN 37027-8080 | 2019-10-28 |
| 1790225662 | Kevin Peterson | General Practice | 3551 Rodger Brooke Dr, Anesthesia Residency, Jbsa-fort Sam Houston, TX 78234-4504 | 2017-02-27 |
| 1174712434 | Kevin Richard Peterson | Pharmacist | 2324 S 156th Cir, Omaha, NE 68130-2511 | 2007-10-23 |
| 1053527895 | Kevin Howard Peterson | Psychologist | 31 Baltimore St, Suite 103, Cumberland, MD 21502-3024 | 2007-05-16 |
| 1154972180 | Kevin Peterson | Nurse Anesthetist, Certified Registered | 500 Harvard St Se, Minneapolis, MN 55455-0363 | 2019-09-20 |
| 1811543895 | Kevin Nicholas Peterson | Physical Therapist | 980 Roosevelt Ste 100, Irvine, CA 92620-3670 | 2019-08-14 |
| 1215412317 | Kevin Bradley Peterson | Audiologist | 21911 76th Ave W Ste 211, Edmonds, WA 98026-7918 | 2018-09-25 |
| 1215466321 | Kevin George Peterson | Physical Therapist | 898 Hampton Rd, Mcdonough, GA 30253-6514 | 2017-06-12 |
| 1538533393 | Kevin Peterson | Massage Therapist | 3005 86th St, Urbandale, IA 50322-4001 | 2015-11-17 |
| 1669633343 | Kevin W. Peterson | Pediatrics | 307 E Scenic Valley Ave, Indianola, IA 50125-4865 | 2008-06-24 |
| Street Address |
1414 MARYLAND AVE E UMPHYSICIANS PHALEN VILLAGE CLINIC |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692403 | Shoua Yang | Pharmacist | 1180 Arcade St., St. Paul, MN 55106 | 2020-09-01 |
| 1477196715 | The Doctors Medical Clinic, P.a. | Family Medicine | 1504 Whitebear Ave, St Paul, MN 55106 | 2019-10-18 |
| 1144870544 | Lucy Anne Claugherty | Technician | 975 Cook Ave E., St. Paul, MN 55106 | 2019-09-17 |
| 1326602756 | Leslie Neher | Student in an Organized Health Care Education/Training Program | 1414 Maryland Avenue East, St. Paul, MN 55106 | 2019-05-01 |
| 1841758851 | Susan Janine Ferrell | Dental Hygienist | East Side Dental, 895 East 7th Street, St Paul, MN 55106 | 2019-03-08 |
| 1811465271 | Care Plus Hha Inc | Home Health | 1299 Arcade Street, Ste 100, St. Paul, MN 55106 | 2018-11-05 |
| 1033696760 | Strong Tower Health | Clinical Nurse Specialist | 1686 Suburban Ave, St Paul, MN 55106 | 2018-07-25 |
| 1861978439 | William Warmka | Physical Therapist | 1385 Phalen Blvd, St. Paul, MN 55106 | 2018-07-17 |
| 1902392111 | Chaffee Dialysis LLC | Clinic/Center | 862 Arcade St, Saint Paul, MN 55106 | 2018-07-11 |
| 1922594217 | Vangneng Xiong | Marriage & Family Therapist | 1299 Arcade St Ste 202, Saint Paul, MN 55106 | 2018-07-10 |
| Find all providers in zip 55106 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336594498 | Jaimi Weber | Family Medicine | Mmc 381, 420 Delaware St. Se, Minneapolis, MN 55445 | 2016-04-26 |
| 1376906388 | Sama Healthcare | Family Medicine | 2639 Nicollet Ave., Suite 130, Minneapolis, MN 55408 | 2016-03-29 |
| 1902209687 | Elaine May | Family Medicine | 2861 Burnham Blvd, Minneapolis, MN 55416-4331 | 2014-10-08 |
| 1952741050 | Gregory Olszewski | Family Medicine | 19 S 1st St Apt B2603, Minneapolis, MN 55401-1845 | 2013-07-03 |
| 1881940864 | Isaac Milton Engholm | Family Medicine | 825 Nicollet Mall Ste 403, Minneapolis, MN 55402-2611 | 2012-07-27 |
| 1942572763 | Neighborhood Healthsource | Family Medicine | 1015 4th Avenue North, Suite 201, Minneapolis, MN 55405-1178 | 2012-02-09 |
| 1225323371 | Yun Chau Bernice Lee | Family Medicine | 2823 Dean Pkwy, Minneapolis, MN 55416-4401 | 2011-06-16 |
| 1730487208 | Specialized Medical Response, LLC | Family Medicine | 401 Harding St Ne #100, Minneapolis, MN 55413 | 2011-03-08 |
| 1285930065 | Allina Health System | Family Medicine | 3024 Snelling Ave S, Minneapolis, MN 55406-1911 | 2011-01-27 |
| 1013226844 | Corban Health Care, Pllc | Family Medicine | 5141 36th Ave S, Minneapolis, MN 55417-1518 | 2010-09-28 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55106 |
Please comment or provide details below to improve the information on KEVIN P PETERSON.
| 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.