Rodney Holmes Peterson, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

16752 Issued in MN

Practice address

3250 W 66TH St
Suite 100
Edina, MN 55435-2528

Phone

(952) 920-0970

Fax

(952) 922-1605

NPI assigned

Aug 15, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Infinite Health Collaborative, PA

  • Orthopaedic Surgery Physician
  • Bloomington, MN
  • NPI 1164474250
  NPD (past)
• Infinite Health Collaborative, PA

  • Durable Medical Equipment & Medical Supplies
  • River Falls, WI
  • NPI 1144608589
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1073526414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 WAYZATA BLVD",
            "address_2": "SUITE 900",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261728",
            "telephone_number": "952-512-5600",
            "fax_number": "952-512-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 W 66TH ST",
            "address_2": "SUITE 100",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352528",
            "telephone_number": "952-920-0970",
            "fax_number": "952-922-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "RODNEY",
        "middle_name": "HOLMES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "16752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "900732",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP14162",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "509S0PE",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISC MEDICAID",
            "identifier": "30298200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "969990831004",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krista Peterson, PSY.D.L.P.
• Matthew Christian Peterson, DPM
• Michelle C Peterson, MS LMFT
• Randolph K. Peterson, M.D.
• Robert K Peterson, DDS
• Stephen Wayne Peterson, LPCC
• Tara Peterson, LICSW, LADC
• Patricia Mary Pettit, M.D.
• Carol Jean Pexa, C.R.N.A.
• Chloe G Peyton, MD

• Orthopaedic Surgery Physician in Edina, MN
• Providers in Edina, MN by specialty
• Orthopaedic Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.