DR. MICHAEL GENE PETERSON (NPI# 1609079094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609079094 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL GENE PETERSON |
| Credential | MD |
| Practice Address |
201 E. Nicollet Blvd. Burnsville MN 55337 |
| Mailing Address |
5435 Feltl Rd Minnetonka MN 55343-7983 |
| Practice Telephone | 6128895480 |
| Mailing Telephone | 9528571504 |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2010-02-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 52328 | MN | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 4301085530 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1609079094 | 05 | |
| MN | MN MEDICAL LICENSE | 52328 | 01 |
| PROVIDER TAXONOMY | 207P00000X | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942794839 | Michael Peterson | Physician Assistant | 3181 Sw Sam Jackson Park Rd # P31, Portland, OR 97239-3098 | 2018-06-14 |
| 1548715634 | Michael Latrae Peterson | Social Worker | 6767 W Windmill Ln, Las Vegas, NV 89139-6501 | 2016-08-18 |
| 1033544119 | Michael Robert Peterson | Counselor | 522 4th St S, Stillwater, MN 55082-4966 | 2013-09-09 |
| 1750651113 | Michael Peterson | Social Worker | 1400 N Hayworth Ave Apt 9, West Hollywood, CA 90046-3836 | 2012-01-03 |
| 1578848131 | Michael Dean Peterson | Dentist | 4710 Amber Valley Pkwy S, Ste A, Fargo, ND 58104 | 2011-10-14 |
| 1467693119 | Michael Lamont Peterson | Registered Nurse | 13 Hollister St, Rochester, NY 14605-1401 | 2009-03-10 |
| 1003062001 | Michael Carl Peterson | Physical Therapist | 2850 Mitchell Rd, Jamestown, NY 14701-8906 | 2008-08-11 |
| 1942472691 | Michael E Peterson | Dentist | 5355 W State St, Boise, ID 83703-3333 | 2008-04-01 |
| 1134325145 | Michael W Peterson | Dentist | 1319 Tennessee St, Vallejo, CA 94590 | 2007-06-26 |
| 1770634909 | Michael Warren Peterson | Dermatology | 114 East 800 North, Spanish Fork, UT 84660 | 2007-01-15 |
| Street Address |
201 E. NICOLLET BLVD. |
| City | BURNSVILLE |
| State | MN |
| Zip Code | 55337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073742375 | Ann Marie Mclaughlin | Clinical Nurse Specialist | 201 E. Nicollet Blvd., Fairview Nicollet Blvd., Burnsville, MN 55337 | 2009-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053939397 | Alpha Quality Care1 L. L. C. | Home Infusion | 12924 18th Ave South, Burnsville, MN 55337 | 2020-07-13 |
| 1568085900 | Kathryn Harris | Counselor | 11939 W. River Hills Dr., Burnsville, MN 55337 | 2020-05-20 |
| 1952941254 | Noah Home Care Inc. | Home Health | 13521 Nicollet Lane, Burnsville, MN 55337 | 2020-01-14 |
| 1750854287 | Baraka Home Care LLC | Nursing Care | 1700 James Place, Burnsville, MN 55337 | 2019-01-08 |
| 1699298778 | Raphael Cheron-dittmann | Hearing Instrument Specialist | 14000 Nicollet Ave. S., Suite 303, Burnsville, MN 55337 | 2017-07-20 |
| 1669909818 | Mercy Home Care Ltd | Hospice Care, Community Based | 1020 E 146th St Ste 220d, Burnsville, MN 55337 | 2017-05-18 |
| 1457893984 | Daniel Ryan Nguyen | Physician Assistant | 14551 Co Rd #11 #100, Burnsville, MN 55337 | 2016-11-15 |
| 1730542572 | Iris Reproductive Psychiatric Clinic | Clinical Nurse Specialist | 1500 Mcandrews Road W, Ste 227, Burnsville, MN 55337 | 2016-03-30 |
| 1740657204 | Mercy Link, LLC | Home Health | 13005 Salem Pl, Burnsville, MN 55337 | 2015-08-31 |
| 1669852158 | Mixa Dipak Patel | Physical Therapy Assistant | 8380 Hiawatha Ave, Eden Prairie, MN 55337 | 2015-06-01 |
| Find all providers in zip 55337 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770926958 | Kyle William Yeager | Emergency Medicine | 303 E Nicollet Blvd Ste 160, Burnsville, MN 55337-4588 | 2013-04-08 |
| 1780624072 | David Franklin Craig | Emergency Medicine | 838 Jr Pate Rd, Burnsville, NC 28714-5880 | 2006-06-07 |
| 1194813287 | Viorel Guter | Emergency Medicine | 14000 Nicollet Ave Ste 100, Burnsville, MN 55337-5793 | 2006-10-11 |
| 1598796732 | Wenlan Cheng | Emergency Medicine | 201 E Nicollet Blvd, Fv Ridges Hospital, Burnsville, MN 55337 | 2006-07-05 |
| 1093742934 | Lucas Paul Mailander | Emergency Medicine | 201 E Nicollet Blvd, Fairview Ridges Hospital, Burnsville, MN 55337 | 2006-06-27 |
| 1326005976 | Lawrence Deshaw | Emergency Medicine | 201 E Nicollet Blvd, Fairview Ridges Hospital, Burnsville, MN 55337 | 2006-04-27 |
| 1962466672 | Barbara Ehler | Emergency Medicine | 201 E Nicollet Blvd, Fairview Ridges Hospital, Burnsville, MN 55337 | 2006-04-12 |
| 1669431714 | Donald Brandt | Emergency Medicine | 201 E Nicollet Blvd, Fairview Ridges Hospital, Burnsville, MN 55337 | 2006-03-18 |
| 1902865058 | James Brian Stowell | Emergency Medicine | 201 E Nicollet Blvd, Burnsville, MN 55337 | 2006-03-18 |
| 1407815558 | Teague Dombeck | Emergency Medicine | 201 E Nicollet Blvd, Fairview Ridges Hospital, Burnsville, MN 55337-5714 | 2006-03-18 |
| Find all providers in BURNSVILLE | ||||
| City | BURNSVILLE |
| Zip Code | 55337 |
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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.