Active NPI
Donald Richard Peters
- Social Worker
- North Branch, MN
National Provider Identifier
1194162586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 13016
- Practice address
- 38460 Lincoln TRL
Suite 106
North Branch, MN 55056-5834 - Phone
- (651) 277-4283
- Fax
- (651) 277-4284
- NPI assigned
- May 27, 2013
- Last updated
- May 27, 2013
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 13016 | MN | Primary |
Addresses
Primary practice location
38460 Lincoln TRL
Suite 106
North Branch, MN 55056-5834
Mailing address
38460 Lincoln TRL Ste 106
P.O. Box 723
North Branch, MN 55056-5834
Phone (651) 277-4283
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13016 | MN | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Haven Center, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- North Branch, MN
- NPI 1801051461
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369612800000",
"number": "1194162586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38460 LINCOLN TRL STE 106",
"address_2": "P.O. BOX 723",
"city": "NORTH BRANCH",
"state": "MN",
"postal_code": "550565834",
"telephone_number": "651-277-4283",
"fax_number": "651-277-4284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38460 LINCOLN TRL",
"address_2": "SUITE 106",
"city": "NORTH BRANCH",
"state": "MN",
"postal_code": "550565834",
"telephone_number": "651-277-4283",
"fax_number": "651-277-4284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "DONALD",
"middle_name": "RICHARD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-27",
"last_updated": "2013-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MN",
"license": "13016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Branch, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.