Timothy A Peterson (NPI# 1134211568, PAC ID# 9739197567) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1134211568 |
| PAC ID by PECOS | 9739197567 |
| Professional Enrollment ID | I20060405000101 |
| Full Name | Timothy A Peterson |
| Organization Legal Name | PETERSON MEDICAL CLINICS LLC |
| Address |
1202 23rd St S Suite 3 Fargo ND 58103-2951 |
| Phone Number | 7017322509 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1992 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | ADDICTION MEDICINE, EMERGENCY MEDICINE |
| Group Practice PAC ID | 9335412220 |
| Number of Group Practice Members | 14 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 350019 | ALTRU HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 519 Anne St Nw, Suite A, Bemidji, MN 56601-4277 | 2184447013 | PETERSON MEDICAL CLINICS LLC |
| 1202 23rd St S, Suite 3, Fargo, ND 58103-2951 | 7017322509 | PETERSON MEDICAL CLINICS LLC |
| 1451 44th Ave S, Suite A, Grand Forks, ND 58201-3434 | 7017322516 | PETERSON MEDICAL CLINICS LLC |
| 103 Fram St, Petersburg, AK 99833 | 7017322509 | PETERSON MEDICAL CLINICS LLC |
| Organization Legal Name | PETERSON MEDICAL CLINICS LLC |
| Physicians | 11 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Riki Hehe-amai Gifford-ferguson | Physician Assistant | Peterson Medical Clinics LLC | 316 Park Ave Se, Renville, MN 56284-2470 |
| David B Eberly | Physician Assistant | Peterson Medical Clinics LLC | 519 Anne St Nw, Suite A, Bemidji, MN 56601-4277 |
| Jessica R Wichmann | Physician Assistant | Peterson Medical Clinics LLC | 519 Anne St Nw, Suite A, Bemidji, MN 56601-4277 |
| Megan Marie Weddingfeld | Nurse Practitioner | Peterson Medical Clinics LLC | 1202 23rd St S, Suite 3, Fargo, ND 58103-2951 |
| Thomas M Peterson | Psychiatry | Peterson Medical Clinics LLC | 1451 44th Ave S, Suite A, Grand Forks, ND 58201-3434 |
| Natasha Marie Krebs | Nurse Practitioner | Peterson Medical Clinics LLC | 1451 44th Ave S, Suite A, Grand Forks, ND 58201-3434 |
| Katie M Allen | Clinical Social Worker | Peterson Medical Clinics LLC | 1202 23rd St S, Suite 3, Fargo, ND 58103-2951 |
| Mio Watanabe | Physician Assistant | Peterson Medical Clinics LLC | 515 Bridge St, Park Rapids, MN 56470-1210 |
| Faith Murray-taylor | Nurse Practitioner | Peterson Medical Clinics LLC | 103 Fram St, Petersburg, AK 99833 |
| Kimber-lee Osowski | Clinical Social Worker | Peterson Medical Clinics LLC | 1451 44th Ave S, Suite A, Grand Forks, ND 58201-3434 |
| Street Address |
1202 23RD ST S SUITE 3 |
| City | FARGO |
| State | ND |
| Zip | 58103-2951 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Megan Marie Weddingfeld | Nurse Practitioner | Peterson Medical Clinics LLC | 1202 23rd St S, Suite 3, Fargo, ND 58103-2951 |
| Katie M Allen | Clinical Social Worker | Peterson Medical Clinics LLC | 1202 23rd St S, Suite 3, Fargo, ND 58103-2951 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gary E Johnson | Optometry | Mark Tufte Od PC | 1801 45th St S, Suite G, Fargo, ND 58103-0801 |
| Mark G Tufte | Optometry | Mark Tufte Od PC | 1801 45th St S, Suite G, Fargo, ND 58103-0801 |
| Anthony Heath Charbonneau | Physical Therapy | Total Balance Physical Therapy and Fitness LLC | 4041 Main Ave, Fargo, ND 58103-1145 |
| Scott B Phillips | Neurosurgery | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Marcus F Keep | Neurosurgery | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Behzad S Sabit | Neurosurgery | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Abdul A Baker | Neurosurgery | Sanford Clinic North | 700 1st Ave S, Fargo, ND 58103-1802 |
| Michael David Manchak | Neurology | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Tahereh Keshavarz | Physician Assistant | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Tong Yang | Neurosurgery | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Find all physicians in zip 58103 | |||
| City | FARGO |
| Zip Code | 58103 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | FARGO + FAMILY MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.