Individual provider Active NPI

Anita S Eshelman-Peters, M.D.

  • Family Medicine Physician
  • Albert Lea, MN
National Provider Identifier
1619956067
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
27680 Issued in IA
Practice address
404 W Fountain St
Albert Lea, MN 56007-2437
Phone
(507) 373-2384
NPI assigned
Jan 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 38164 MN
Family Medicine Physician 207Q00000X 27680 IA Primary

Addresses

Primary practice location

404 W Fountain St
Albert Lea, MN 56007-2437

Mailing address

40050 210TH Ave
Lake Mills, IA 50450-7624
Phone (641) 592-2361

Other identifiers 1

IdentifierTypeStateIssuer
477215600MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100817000823 IA Practitioner - Family Practice 7416907498 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Sep 1, 1997 Accepting new patients
Floyd County Memorial Hospital Commission Family Medicine Past Accepting new patients

Locations

406 S 10th Ave E
Lake Mills, IA 50450
Phone (641) 592-4900

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

301 S Broadway
Wells, MN 56097
Phone (507) 553-6341

Interoperability endpoints

  • Direct secure messaging: apeters89442@ehrdirect.mayoclinicmsg.org

Organizations & group practices 3

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 Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1619956067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40050 210TH AVE",
            "city": "LAKE MILLS",
            "state": "IA",
            "postal_code": "504507624",
            "telephone_number": "641-592-2361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 W FOUNTAIN ST",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560072437",
            "telephone_number": "507-373-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESHELMAN-PETERS",
        "first_name": "ANITA",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "38164",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "27680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "477215600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albert Lea, MN

Sources for this page

Verify at the official NPI Registry.