Active NPI
Michael Donald Peterson, PHARMD
- Pharmacist
- Minot, ND
National Provider Identifier
1184237471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH5294
- Practice address
- 1 Burdick Expy W
Minot, ND 58701-4406 - Phone
- (701) 857-5550
- NPI assigned
- Aug 26, 2020
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH5294 | ND | Primary |
Addresses
Primary practice location
1 Burdick Expy W
Minot, ND 58701-4406
Mailing address
1100 32ND Ave SE
Minot, ND 58701-7103
Phone (701) 315-0163
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH5294 | ND | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598400000000",
"number": "1184237471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 32ND AVE SE",
"city": "MINOT",
"state": "ND",
"postal_code": "587017103",
"telephone_number": "701-315-0163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BURDICK EXPY W",
"city": "MINOT",
"state": "ND",
"postal_code": "587014406",
"telephone_number": "701-857-5550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "MICHAEL",
"middle_name": "DONALD",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-26",
"last_updated": "2020-08-26",
"certification_date": "2020-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ND",
"license": "RPH5294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minot, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.