Christine Rennae Peterson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

MN 2563 Issued in MN

Practice address

1213 Gilmore Ave
Winona, MN 55987-2474

Phone

(507) 454-1792

Fax

(507) 454-1793

NPI assigned

Sep 17, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1497852040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1363 GRANDVIEW CT",
            "city": "MINNESOTA CITY",
            "state": "MN",
            "postal_code": "559591209",
            "telephone_number": "507-494-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 GILMORE AVE",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559872474",
            "telephone_number": "507-454-1792",
            "fax_number": "507-454-1793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CHRISTINE",
        "middle_name": "RENNAE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "MN 2563",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2885 - 035",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52P81PE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2202971",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Savanna Perkins
• Abigail Faith Peshon
• Peter J. Zehren D.D.S.,S.C.
• Ashley Peters
• Desirae Peters
• Gregory Wayne Peterson, DC
• Jessica Lynn Peterson
• Maren Michaela Peterson
• Matthew Peterson
• Natalie Morgan Peterson

• Optometrist in Winona, MN
• Providers in Winona, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.