SCOTT PETERSON (NPI# 1598121808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598121808 |
| Entity Type | Individual |
| Full Name | SCOTT PETERSON |
| Credential | D.O. |
| Practice Address |
3777 Coon Rapids Blvd Nw Ste 100 Coon Rapids MN 55433-2630 |
| Practice Telephone | 7634217420 |
| Practice Fax Number | 7634210730 |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 5101019986 | MI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 168 S Howell St, Hillsdale, MI 492422040 | 5174375192 | 5174375194 |
| 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 |
| 1720492655 | Scott Peterson | Marriage & Family Therapist | 1880 River Rd, Grand Rapids, MN 55744-4085 | 2014-06-18 |
| Street Address |
3777 COON RAPIDS BLVD NW STE 100 |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-2630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922038926 | Timothy Eggimann | Optometrist | 3777 Coon Rapids Blvd Nw Ste 100, Coon Rapids, MN 55433-2630 | 2006-07-04 |
| 1760968895 | Margaret Mary Shipitalo | Optometrist | 3777 Coon Rapids Blvd Nw Ste 100, Coon Rapids, MN 55433-2630 | 2018-07-11 |
| 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 | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083935068 | George Randall Wandling Jr. | Ophthalmology | 3777 Coon Rapids Blvd Nw # 100, Coon Rapids, MN 55433-2630 | 2010-06-14 |
| 1740275833 | Byron A Teska | Ophthalmology | 3960 Coon Rapids Blvd Nw, Suite 304, Coon Rapids, MN 55433-2569 | 2005-09-14 |
| 1083617849 | James Adair Cameron | Ophthalmology | 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433 | 2005-05-24 |
| 1669475414 | Alfred Oscar Steldt | Ophthalmology | 3790 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2629 | 2005-05-24 |
| 1558593004 | Matthew Sander Johnson | Ophthalmology | 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433 | 2009-08-18 |
| 1912151929 | David V Folden | Ophthalmology | 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433 | 2008-11-05 |
| 1689870156 | North Suburban Eye Specialists, LLP | Ophthalmology | 3790 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2629 | 2007-06-22 |
| 1710190939 | Patrick Kelly Johnson | Ophthalmology | 3790 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2629 | 2007-05-07 |
| 1205870045 | Mark Lobanoff | Ophthalmology | 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194290486 | Eye Care Associates, Pa | Ophthalmology | 710 E 24th St Ste 101-201, Minneapolis, MN 55404-3840 | 2018-10-12 |
| 1548794316 | Trevor Kindle | Ophthalmology | 200 1st Ave Nw, Rochester, MN 55901 | 2017-04-18 |
| 1790228294 | Eye Associates of Central Minnesota Pa | Ophthalmology | 628 Roosevelt Rd, Suite 101, Saint Cloud, MN 56301-4867 | 2016-12-01 |
| 1093160491 | Christina Gillmor | Ophthalmology | 516 Delaware St Se Fl 9, Minneapolis, MN 55455-0356 | 2016-05-04 |
| 1861889776 | Michael Andrew Jordan | Ophthalmology | 825 Nicollet Mall Ste 2000, Minneapolis, MN 55402-2708 | 2015-04-17 |
| 1467872390 | Luke Dolezal | Ophthalmology | 5851 Duluth St Ste 215, Golden Valley, MN 55422-3956 | 2014-04-17 |
| 1811330939 | James Layer | Ophthalmology | 3708 Upton Ave S, Minneapolis, MN 55410-1237 | 2013-04-08 |
| 1093058158 | Hao Tang | Ophthalmology | 7760 France Ave S Ste 310, Edina, MN 55435 | 2013-03-27 |
| 1407112881 | Phillip Michael Armand Radke | Ophthalmology | 7450 France Ave S Ste 100, Edina, MN 55435-4799 | 2012-04-10 |
| 1023374964 | Sasha Strul | Ophthalmology | 701 25th Ave S Ste 300, Minneapolis, MN 55454-1443 | 2012-04-04 |
| Find all providers with the same taxonomy | ||||
| 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.