Active NPI
Sarah Peterson
- Pharmacist
- Moorhead, MN
National Provider Identifier
1245508969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 120496
- Practice address
- 900 Main Ave
Moorhead, MN 56560-2802 - Phone
- (218) 236-0252
- Fax
- (218) 236-8962
- NPI assigned
- Dec 8, 2011
- Sex
- Female
- 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 | 120496 | MN | Primary |
Addresses
Primary practice location
900 Main Ave
Moorhead, MN 56560-2802
Mailing address
900 Main Ave
Moorhead, MN 56560-2802
Phone (218) 236-0252
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 |
|---|---|---|---|
| 120496 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323302400000",
"number": "1245508969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 MAIN AVE",
"city": "MOORHEAD",
"state": "MN",
"postal_code": "565602802",
"telephone_number": "218-236-0252",
"fax_number": "218-236-8962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 MAIN AVE",
"city": "MOORHEAD",
"state": "MN",
"postal_code": "565602802",
"telephone_number": "218-236-0252",
"fax_number": "218-236-8962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "SARAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-08",
"last_updated": "2011-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "120496",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moorhead, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.