KEITH HERSHEL PETERSON (NPI# 1689718637) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689718637 |
| Entity Type | Individual |
| Full Name | KEITH HERSHEL PETERSON |
| Credential | MD |
| Practice Address |
400 E 3rd St Essentia Health Duluth Clinic Duluth MN 55805-1951 |
| Practice Telephone | 2187864020 |
| Mailing Telephone | 2187864020 |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2015-12-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 62724-20 | WI | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | 49588 | MN | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 49588 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1689718637 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275143562 | Keith Hjalmar Jude Peterson | Registered Nurse | 77 Park Ave Apt 127, Hoboken, NJ 07030-7106 | 2020-08-03 |
| 1023144573 | Keith R Peterson | Psychologist | 6 Venture, Suite 350, Irvine, CA 92618-3340 | 2007-02-26 |
| 1972679439 | Keith A Peterson | Chiropractor | 1205 Hauck Dr, Rolla, MO 65401-4900 | 2006-11-28 |
| 1124086731 | Keith E Peterson | Otolaryngology | 2528 W 16th St, Greeley, CO 80634-4955 | 2006-05-03 |
| Street Address |
400 E 3RD ST ESSENTIA HEALTH DULUTH CLINIC |
| City | DULUTH |
| State | MN |
| Zip Code | 55805-1951 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134122799 | Janet S. Bennett | Nurse Practitioner | 400 E 3rd St, Duluth, MN 55805-1951 | 2005-05-27 |
| 1386250454 | Erin Elizabeth Kukowski | Nurse Anesthetist, Certified Registered | 400 E 3rd St, Duluth, MN 55805-1951 | 2020-09-23 |
| 1760096416 | Janine M Cook | Nurse Practitioner | 400 E 3rd St, Duluth, MN 55805-1951 | 2020-09-01 |
| 1912510694 | Emily Stunek | Nurse Practitioner | 400 E 3rd St, Duluth, MN 55805-1951 | 2020-08-24 |
| 1831709781 | Sarah Ann Yokel | Nurse Practitioner | 400 E 3rd St, Duluth, MN 55805-1951 | 2020-08-05 |
| 1063020352 | Natalie R Halverson | Speech-Language Pathologist | 400 E 3rd St, Duluth, MN 55805-1951 | 2020-07-22 |
| 1588272470 | Danielle M Huber | Clinical Neuropsychologist | 400 E 3rd St, Duluth, MN 55805-1951 | 2020-07-17 |
| 1326663733 | Bonnie M Gustafson | Nurse Practitioner | 400 E 3rd St, Duluth, MN 55805-1951 | 2020-06-11 |
| 1265057640 | Sonja E Hanson | Registered Nurse | 400 E 3rd St, Duluth, MN 55805-1951 | 2020-06-11 |
| 1588203061 | Erin Laveau-allen | Student in an Organized Health Care Education/Training Program | 400 E 3rd St, Duluth, MN 55805-1951 | 2019-12-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356852180 | Peace of Mind of Duluth, Inc. | Community/Behavioral Health | 1000 East 1st Street, Suite 100, Duluth, MN 55805 | 2017-10-19 |
| 1891213419 | Arielle Skalisky | Registered Nurse | 400 E. 3rd Street, Duluth, MN 55805 | 2017-09-04 |
| 1457886400 | Chefrdn, LLC | Dietitian, Registered | 1101 East 4th Street, Duluth, MN 55805 | 2017-04-27 |
| 1962811604 | Claire Elena Kap | Nurse Practitioner | Essentia Health Duluth Clnic, 400 East Third Street, Duluth, MN 55805 | 2014-08-06 |
| 1598196313 | Kelsey Lindsay Putvin | Audiologist | 400 E 3rd St., Duluth, MN 55805 | 2013-12-04 |
| 1639462997 | James F Conniff | Family Medicine | Duluth Family Medicine Clinic, 330 N Eighth Ave E, Duluth, MN 55805 | 2011-05-19 |
| 1215237433 | Bobby Jo Mineheine | Speech-Language Pathologist | 530 East Second St, Polinsky Medical Rehab Ctr, Duluth, MN 55805 | 2010-10-22 |
| 1891004248 | Robin Michelle Warfel | Occupational Therapist | 530 East 2nd Street, Polinsky Medical Rehabilitation Center, Duluth, MN 55805 | 2010-10-04 |
| 1154638716 | Jennifer Chen | Pharmacist | 420 E 1st St Mail Drop 1s3w10, Duluth, MN 55805 | 2010-09-02 |
| 1376858084 | Jennifer Lynn Howard | Pharmacist | 211 West Fourth Street, Center for American Indian Resources, Duluth, MN 55805 | 2010-08-18 |
| Find all providers in zip 55805 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427664333 | Nations Medical Clinic Inc | Internal Medicine | 3099 Bredkinridge Blvd, Suite 110/111, Duluth, GA 30096-1011 | 2020-09-17 |
| 1659986057 | Herman Medical Solutions, LLC | Internal Medicine | 10700 Medlock Bridge Road, Suite 207, Duluth, GA 30097 | 2020-09-11 |
| 1891193082 | Connie Hall Shrake | Internal Medicine | 3380 Moye Trl, Duluth, GA 30097-3780 | 2014-12-20 |
| 1336546662 | Robert Derro | Internal Medicine | 3662 Howell Wood Trl, Duluth, GA 30096-4803 | 2014-12-02 |
| 1992137962 | Nandi Md Incorporated | Internal Medicine | 8510 Prairie Dunes Way, Duluth, GA 30097-6666 | 2013-08-01 |
| 1730317827 | Swapna Devanna | Internal Medicine | 1001 E Superior St Ste L101, Duluth, MN 55802 | 2009-06-26 |
| 1699933226 | Shreya Raja | Internal Medicine | 5355 Northwater Way, Duluth, GA 30097-6424 | 2008-05-30 |
| 1306028410 | Christina H. Bastin Dejong | Internal Medicine | 400 E. 3rd St., Duluth Clinic, Duluth, MN 55805 | 2007-11-30 |
| 1588798706 | Susanne Pearce | Internal Medicine | 324 W. Superior St, Suite 625, Duluth, MN 55802 | 2007-03-16 |
| 1629122684 | Priority Primary Care | Internal Medicine | 3540 Duluth Park Ln Ste 170, Duluth, GA 30096-8721 | 2007-01-23 |
| Find all providers in DULUTH | ||||
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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.