Jerome R Peterson, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

19789 Issued in MN

Practice address

8450 Seasons Pkwy
Woodbury, MN 55125-4402

Phone

(612) 339-3663

Fax

(651) 702-5305

NPI assigned

Feb 17, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1336114966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 34TH AVE S",
            "address_2": "MAIL STOP 33100A",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251672",
            "telephone_number": "952-883-5463",
            "fax_number": "952-883-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8450 SEASONS PKWY",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254402",
            "telephone_number": "612-339-3663",
            "fax_number": "651-702-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JEROME",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "19789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Peterson
• Christopher Peterson, PHARMD
• Donna Ellena Peterson, MA LP
• Elliana Lein Peterson
• Jenna Peterson
• Michele L Peterson, MD
• Nathan Daniel Peterson, PA-C
• Ramsey Evan Peterson, MD
• Tyler James Peterson, D.C.
• Amanda Jo Petri, M.A.

• Emergency Medicine Physician in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Emergency Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.