Active NPI
Lawrence P Peterson
- Psychiatry Physician
- Rochester, MN
National Provider Identifier
1013961622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 020302
- Practice address
- 210 9TH St SE
Rochester, MN 55904-6425 - Phone
- (507) 288-3443
- NPI assigned
- May 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 020302 | MN | Primary |
Addresses
Primary practice location
210 9TH St SE
Rochester, MN 55904-6425
Mailing address
210 9TH St SE
Rochester, MN 55904-6425
Phone (507) 288-3443
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020302 | MN | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316476800000",
"number": "1013961622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 9TH ST SE",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559046425",
"telephone_number": "507-288-3443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 9TH ST SE",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559046425",
"telephone_number": "507-288-3443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "LAWRENCE",
"middle_name": "P",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2011-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MN",
"license": "020302",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.