Mason Andrew Peterson

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

146775 Issued in ND

Practice address

201 University Dr S
Fargo, ND 58103-1775

Phone

(701) 239-3000

NPI assigned

Jul 31, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sunrise Youth Services Inc

  • General Practice Physician
  • Fargo, ND
  • NPI 1609606805
  NPD Authorized official

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1427887025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 5TH ST NW APT 14",
            "city": "DILWORTH",
            "state": "MN",
            "postal_code": "565291086",
            "telephone_number": "701-639-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031775",
            "telephone_number": "701-239-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MASON",
        "middle_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "ND",
            "license": "146775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiff Elizabeth Peterson
• Lindsey Marie Sloan Peterson, NP
• Lorene Mae Peterson, OTR
• Mari Peterson, RN, BAN
• Marian K Peterson
• Melody R Peterson, LAC
• Michael Dean Peterson, D.D.S., M.S.
• Nancy Peterson, LPN
• Paul Peterson
• Rachael Peterson

• Nurse's Aide in Fargo, ND
• Providers in Fargo, ND by specialty
• Nurse's Aide in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.