Matthew Adam Peterson, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

R33126 Issued in ND

Practice address

198 125TH Ave NE
Finley, ND 58230-9422

Phone

(207) 360-9218

NPI assigned

Dec 29, 2011

Last updated

Jun 15, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1356610810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 125TH AVE NE",
            "city": "FINLEY",
            "state": "ND",
            "postal_code": "582309422",
            "telephone_number": "207-360-9218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 125TH AVE NE",
            "city": "FINLEY",
            "state": "ND",
            "postal_code": "582309422",
            "telephone_number": "207-360-9218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MATTHEW",
        "middle_name": "ADAM",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-29",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201143593RN",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WA",
            "license": "RN60364923",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "ND",
            "license": "R33126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• County of Steele (Office of Auditor)
• Kathy Ellis Good, RN
• Sherry Lynae Loen-Bakke, OTR/L
• Yvonne Mawudeku
• Kirsten D Peterson, MD
• Union Hospital (MeritCare Mayville Union Hospital Finley Clinic)
• Union Hospital
• Union Hospital Society of Mayville ND (Union Hospital Finley Clinic)
• Jesseca Mae Wolff

• Psychiatric/Mental Health Registered Nurse in Finley, ND
• Providers in Finley, ND by specialty
• Psychiatric/Mental Health Registered Nurse in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.