DR. JOHN WILLIAM PETERSEN (NPI# 1720110737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720110737 |
| Entity Type | Individual |
| Full Name | DR. JOHN WILLIAM PETERSEN |
| Credential | D.C. |
| Practice Address |
12000 Elm Creek Blvd N Ste L70 Maple Grove MN 55369-7167 |
| Practice Telephone | 7634204111 |
| Mailing Telephone | 7634204111 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111NN0400X |
Chiropractor Specialization: Neurology |
1764 | MN | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962646224 | John Thomas Petersen | Registered Nurse | 1901 Medi Park Dr Ste 2051, Amarillo, TX 79106-2169 | 2009-04-29 |
| 1497973630 | John Robert Petersen | Chiropractor | 2216 County Road D W, Saint Paul, MN 55112-7500 | 2007-04-23 |
| 1851491526 | John Anthony Petersen | Psychologist | 922 E Wayne St # 205, South Bend, IN 46617-3024 | 2006-09-23 |
| 1790786895 | John Peter Petersen | Radiology | 3555 10th Court, Indian River Regional Cancer Center, Irmc, Vero Beach, FL 32960-4862 | 2005-08-10 |
| 1508422411 | John Robert Petersen | Dentist | 4555 Erin Dr, Eagan, MN 55122-3398 | 2019-05-15 |
| 1619361805 | John Devin Petersen | Pediatrics | 757 Westwood Plz, B711 Rrumc, Los Angeles, CA 90095-7419 | 2015-03-25 |
| 1841587854 | John Roger Petersen | Pathology | 301 University Blvd, Galveston, TX 77555-0551 | 2011-06-29 |
| 1114167434 | John Seigfred Petersen | Dentist | 415 Central Ave, Whitefish, MT 59937-2770 | 2009-02-26 |
| 1588868939 | John William Petersen | Internal Medicine | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2007-06-11 |
| 1164580429 | John J Petersen | Physician Assistant | 520 Medical Center Dr, Suite 201, Medford, OR 97504-4334 | 2006-12-05 |
| Street Address |
12000 ELM CREEK BLVD N STE L70 |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55369-7167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285100263 | Lynn Renee Borgmann | Counselor | 12000 Elm Creek Blvd N Ste L70, Maple Grove, MN 55369-7167 | 2018-10-17 |
| 1720580814 | Indigenous Circles Counseling Center | Clinic/Center | 12000 Elm Creek Blvd N Ste L70, Maple Grove, MN 55369-7167 | 2018-03-05 |
| 1346590627 | Sheanne Scherber | Counselor | 12000 Elm Creek Blvd N Ste L70, Maple Grove, MN 55369-7167 | 2012-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144188 | Bonnie Rose Theis | Counselor | 24 3rd Ave Ne, Unit B, Osseo, MN 55369 | 2020-11-06 |
| 1356976328 | Kirollos Samir Hanna | Pharmacist | 14500 99th Ave N, Suite 0a030, Maple Grove, MN 55369 | 2020-03-10 |
| 1396395463 | Susan Osborne | Technician | 9240 Orchid Lane, Maple Grove, MN 55369 | 2019-09-19 |
| 1710537196 | Janis Langsdale | Technician | 11070 108 Avenue North, Maple Grove, MN 55369 | 2019-09-17 |
| 1043724552 | Tracey Wahlquist | Speech-Language Pathologist | 11100 86th Ave N, Maple Grove, MN 55369 | 2017-11-20 |
| 1154860005 | Kayla Uptagrafft | Specialist/Technologist | 9555 Upland Lane Norh, Maple Grove, MN 55369 | 2017-02-13 |
| 1750823324 | Jennifer Ranallo | Social Worker | 9600 Upland Ln N Ste 110, Maple Grove, MN 55369 | 2016-11-13 |
| 1558723999 | Debra Grace Boersma | Advanced Practice Midwife | 9825 Hospital Dr#205, Maple Grove, MN 55369 | 2016-03-24 |
| 1396129433 | Maple Grove Smiles Dentistry, PC | Dentist | 12775 Elm Creek Blvd N, Maple Grove, MN 55369 | 2015-07-18 |
| 1558755900 | Krista Newman | Counselor | 24 3rd St Nw, Unit B, Osseo, MN 55369 | 2015-03-24 |
| Find all providers in zip 55369 | ||||
| Taxonomy Code | 111NN0400X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Neurology |
| Chiropractic Neurology is defined as the field of functional neurology that engages the internal - and external environment of the individual in a structured and targeted approach to affect positive changes in the nervous system and consequently the physiology and behavior of an individual. Chiropractic Neurologists are board-certified specialists in non-drug, non-surgical care for those with neurologically based health problems. There are many conditions people suffer from that are in this broad category: learning and attention disorders, headaches, vertigo, pain syndromes, developmental disorders, nerve injury, spinal cord injury, head injury or stroke, movement disorders, and many other conditions. |
| Notes: Source: American Chiropractic Neurology Board, 2008 & American Chiropractic Association, 2008 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710523303 | Cody J Dessellier | Chiropractor | 1539 E 7th St, Monticello, MN 55362-4674 | 2019-11-19 |
| 1396221966 | Northern Hope Functional Neurology and Chiropractic | Chiropractor | 25503 Main St, Nisswa, MN 56468-5000 | 2018-07-16 |
| 1609373372 | Joshua Campbell Sweeney | Chiropractor | 6133 Blue Circle Dr Ste 100, Minnetonka, MN 55343-9173 | 2018-04-10 |
| 1790114049 | Joshua Wallert | Chiropractor | 4490 Erin Dr, Eagan, MN 55122 | 2013-11-07 |
| 1083923460 | Pietila Chiropractic | Chiropractor | 12358 River Ridge Blvd, Burnsville, MN 55337-1665 | 2010-10-01 |
| 1205047800 | Robert Joel Gustafson | Chiropractor | 2215 2nd St Sw, Suite 140, Rochester, MN 55902-4147 | 2007-05-24 |
| 1710014311 | Anthony Spurrill | Chiropractor | 4480 Erin Dr, Eagan, MN 55122-2357 | 2007-02-28 |
| 1710020698 | Michelle Eddy | Chiropractor | 141 E Broadway St # 4, Monticello, MN 55362-9322 | 2007-02-14 |
| 1346388261 | Rashid Ali Hassen | Chiropractor | 1113 E Franklin Ave, Suite 101, Minneapolis, MN 55404-2974 | 2007-02-02 |
| 1861539777 | Kenwood Merlyn Rund | Chiropractor | 1123 Hennepin Ave, Glencoe, MN 55336-2206 | 2007-01-31 |
| Find all providers with the same taxonomy | ||||
| City | MAPLE GROVE |
| Zip Code | 55369 |
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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.