Active NPI
Robin Peterson, PHARMD
- Pharmacist
- Saint Paul, MN
National Provider Identifier
1346694189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 122473
- Practice address
- 2197 Old Hudson Rd
Saint Paul, MN 55119-4404 - Phone
- (651) 501-4934
- Fax
- (651) 501-7453
- NPI assigned
- Apr 18, 2016
- Last updated
- Dec 13, 2020
- 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 | 122473 | MN | Primary |
Addresses
Primary practice location
2197 Old Hudson Rd
Saint Paul, MN 55119-4404
Mailing address
284 Spring St Unit 302
Saint Paul, MN 55102-4482
Phone (612) 309-0881
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 |
|---|---|---|---|
| 122473 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Supervalu Pharmacies Inc. | Past | Accepting new patients | |
| NPI 1487760898 | 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 1487760898
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607817600000",
"number": "1346694189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "284 SPRING ST UNIT 302",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551024482",
"telephone_number": "612-309-0881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2197 OLD HUDSON RD",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551194404",
"telephone_number": "651-501-4934",
"fax_number": "651-501-7453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "ROBIN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-18",
"last_updated": "2020-12-13",
"certification_date": "2020-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "122473",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.