MR. RANDY WAYNE PETERSON (NPI# 1730747221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730747221 |
| Entity Type | Individual |
| Full Name | MR. RANDY WAYNE PETERSON |
| Credential | APRN, CNP |
| Practice Address |
716 South 7th Street Purple Building, P1.600 Minneapolis MN 55415 |
| Mailing Address |
11041 Drew Ave S Bloomington MN 55431-3840 |
| Practice Telephone | 6128733000 |
| Mailing Telephone | 6123901683 |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2020-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | R214182-8 | MN | Nursing Service Providers |
| Y | 363L00000X | Nurse Practitioner | 7781 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11041 Drew Ave S, Bloomington, MN 554313840 | 6123901683 | |
| 6401 France Ave S, Edina, MN 554352104 | 9529245600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043419757 | Randy Peterson | Registered Nurse | 627 N Evans St, Mcminnville, OR 97128-3923 | 2007-07-12 |
| 1881969525 | Randy Peterson | Case Manager/Care Coordinator | 7 Prospect St, Nashua, NH 03060-3921 | 2012-03-13 |
| 1235109430 | Randy J Peterson | Specialist | 1527 Broadway St, Alexandria, MN 56308-2537 | 2006-01-23 |
| Street Address |
716 SOUTH 7TH STREET PURPLE BUILDING, P1.600 |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720501117 | Dominique Lacha Jones | Advanced Practice Midwife | 716 South 7th Street, Purple Building Level 5, Minneapolis, MN 55415 | 2017-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114547643 | Kevin Reininger | Pharmacist | 730 S 8th St., Pharmacy Department, Minneapolis, MN 55415 | 2020-04-24 |
| 1124674551 | Andrew Michael Baker | Pathology | Hennepin County Medical Examiner, 530 Chicago Ave, Minneapolis, MN 55415 | 2019-08-12 |
| 1598326951 | Monazza Iqbal Chaudhry | Student in an Organized Health Care Education/Training Program | Hennepin County Medical Center 701 Park Avenue, Minneapolis, MN 55415 | 2019-06-26 |
| 1760947196 | Brandon Haas | Pharmacist | 701 Park Ave Rll, Minneapolis, MN 55415 | 2019-02-11 |
| 1710474192 | Andrea Kramer | Student in an Organized Health Care Education/Training Program | Hennepin County Medical Center Emergency Medicine, 701 Park Avenue, Minneapolis, MN 55415 | 2018-04-20 |
| 1750888640 | Alexandra Rose Coward | Student in an Organized Health Care Education/Training Program | Hennepin County Medical Center - General Surgery, 701 Park Avenue, Minneapolis, MN 55415 | 2018-04-09 |
| 1194235861 | Gretchen Jane Vanderlinden-wang | Social Worker | Hennepin County Medical Center Adult Psychiatry Clinic, 701 Park Avenue, Shapiro Building, Suite S1.110, Minneapolis, MN 55415 | 2017-10-06 |
| 1669905618 | Joseph Douglas Steffens | Internal Medicine | 701 Park Avenue, Internal Medicine Residency Program, Hennepin County Medical Center, Minneapolis, MN 55415 | 2017-04-06 |
| 1215469689 | Michael Reitz | Student in an Organized Health Care Education/Training Program | 701 Park Avenue, B5.118, Minneapolis, MN 55415 | 2017-04-03 |
| 1528515194 | Regents of The University of Minnesota | Clinic/Center | 814 S 3rd Street, Minneapolis, MN 55415 | 2016-09-01 |
| Find all providers in zip 55415 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841803970 | Kelsey Olson | Nurse Practitioner | 2450 Riverside Ave Fl 9, Minneapolis, MN 55454-1450 | 2020-08-28 |
| 1396373932 | Hayley Starr Gifford | Nurse Practitioner | 33 105th Ave Nw, Minneapolis, MN 55448-5044 | 2020-03-30 |
| 1225535701 | Karissa Dougherty | Nurse Practitioner | 2200 E Franklin Ave # 199, Minneapolis, MN 55404 | 2018-04-10 |
| 1831646108 | Ingrid Estephan | Nurse Practitioner | 2929 21st Ave S Apt 301, Minneapolis, MN 55407-4515 | 2016-09-05 |
| 1730532631 | Allina Health System | Nurse Practitioner | 913 E 26th St Ste 305, Minneapolis, MN 55404-4515 | 2016-07-15 |
| 1619376860 | Amy Cooley | Nurse Practitioner | 800 E 28th St # H2100, Minneapolis, MN 55407 | 2014-08-13 |
| 1710265368 | Kimberly Dawn Moore | Nurse Practitioner | 814 South 3rd Street, Minneapolis, MN 55415 | 2011-08-01 |
| 1164700878 | Katherine Casey Martin Caughel | Nurse Practitioner | Hcmc, 701 Park Ave, Surgery Department, P-5, Minneapolis, MN 55415-1623 | 2011-07-29 |
| 1386951358 | Jody Michelle Schoenecker | Nurse Practitioner | 615 1st Ave Ne Ste 310, Minneapolis, MN 55413-2419 | 2010-09-10 |
| 1043543093 | Therese Mary Maas | Nurse Practitioner | 909 Fulton St Se Ste 300, Minneapolis, MN 55455 | 2009-09-09 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55415 |
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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.