Shaina Peterson, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10368 Issued in MN

Practice address

1900 Centracare Cir Ste 1575
Saint Cloud, MN 56303-5000

Phone

(320) 229-4922

NPI assigned

Aug 5, 2020

Sex

Female

Sole proprietor

No

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.

• Pediatric Therapy Partners, Inc.

  • Occupational Therapist
  • Thief River Falls, MN
  • NPI 1457479958

  ND, Speech-Language Pathologist

  Medicare reassignment NPD
• Pediatric Therapy Partners, Inc.

  • Early Intervention Provider Agency
  • Fargo, ND
  • NPI 1104426352
  NPD

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 31, 2021.

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1174133003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR STE 1575",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR STE 1575",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-4922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 45th St S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581048970",
            "country_code": "US",
            "telephone_number": "701-356-4384",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3060 Frontier Way S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581048909",
            "country_code": "US",
            "telephone_number": "701-232-2340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SHAINA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "10368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Joan Peterson, RN CAGNP
• Nicole E Peterson, P.T.
• Paul Charles Peterson, MD
• Richard Allen Peterson, RN
• Russell Thomas Peterson, DDS
• Susan A Peterson, CRNA
• Tara Peterson
• Theodore A Peterson, M.D.
• Thomas M Peterson, PT
• Thomas Merlin Peterson, DDS

• All providers in Saint Cloud, MN
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.