Active NPI
Eric Julian Peterson, CRNA,MSN
- Certified Registered Nurse Anesthetist
- Willmar, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 53163, R131880-1
- Practice address
- 301 Becker Ave SW
Willmar, MN 56201-3302 - Phone
- (320) 231-4120
- NPI assigned
- Jun 9, 2005
- Last updated
- Mar 29, 2023
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 53163, R131880-1 | MN | Primary |
Addresses
Primary practice location
301 Becker Ave SW
Willmar, MN 56201-3302
Mailing address
1011 15TH Ave NW
Willmar, MN 56201-2138
Phone (320) 214-1222
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | epeterson29800@direct.centracare.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
600 Peterson Pkwy
New London, MN 56273-7823
Phone (320) 354-2222
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse, Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53163, R131880-1 | MN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CCM Health | Current | Accepting new patients | |
| Centracare Clinic Southwest LLC | Current | Accepting new patients | |
| Minnesota Pathologists Chartered | Current | Accepting new patients | |
| Centracare Clinic Southwest LLC | Current | Accepting new patients | |
| CCM Health | Current | Accepting new patients |
Locations
824 N 11th St
Montevideo, MN 56265
Phone (320) 269-8877
600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222
1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342
1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657
301 Becker Ave SW
Willmar, MN 56201
Phone (320) 231-4120
101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079
Interoperability endpoints
- epeterson29800@direct.centracare.com
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Willmar, MN
- NPI 1174106264
-
- Critical Access Hospital
- Montevideo, MN
- NPI 1720086028
-
- Rural Health Clinic/Center
- Milan, MN
- NPI 1457132466
-
- Durable Medical Equipment & Medical Supplies
- Willmar, MN
- NPI 1912664889
-
- Anatomic Pathology & Clinical Pathology Physician
- Willmar, MN
- NPI 1992851315
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba CentraCare - Rice Memorial Hospital
- Infusion Therapy Clinic/Center
- Willmar, MN
- NPI 1124657150
Hospital
-
dba CentraCare - Rice Memorial Hospital
- General Acute Care Hospital
- Willmar, MN
- NPI 1407367030
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680048000000",
"number": "1265436059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 15TH AVE NW",
"city": "WILLMAR",
"state": "MN",
"postal_code": "562012138",
"telephone_number": "320-214-1222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 BECKER AVE SW",
"city": "WILLMAR",
"state": "MN",
"postal_code": "562013302",
"telephone_number": "320-231-4120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "ERIC",
"middle_name": "JULIAN",
"credential": "CRNA,MSN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-09",
"last_updated": "2023-03-29",
"certification_date": "2023-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "53163, R131880-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "epeterson29800@direct.centracare.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "epeterson29800@direct.centracare.com",
"address_1": "301 Becker Ave SW",
"city": "Willmar",
"state": "MN",
"country_code": "US",
"postal_code": "562013302",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Willmar, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.