NPIMap

Organization Active NPI

Debra I.Peterson PC

  • Addiction (Substance Use Disorder) Counselor
  • Jamestown, ND
National Provider Identifier
1699983932
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1075 Issued in ND
Legal business name
DEBRA I.PETERSON PC
Practice address
300 2ND Ave NE
Suite 221
Jamestown, ND 58401-3373
Phone
(701) 252-5398
Fax
(701) 252-5398
NPI assigned
May 18, 2007
Last updated
Jun 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Authorized official

Name
Ms. Debra Irene Peterson, LACNPI 1770603813
Title
Director
Phone
(701) 252-5398

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1075 ND Primary

Addresses

Primary practice location

300 2ND Ave NE
Suite 221
Jamestown, ND 58401-3373

Mailing address

PO Box 874
Jamestown, ND 58402-0874
Phone (701) 252-5398

Other identifiers 1

IdentifierTypeStateIssuer
12115MedicaidND

National Provider Directory

National Provider Directory

Locations

300 2nd Ave NE
Ste 221
Jamestown, ND 58401
Phone (701) 252-5398

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1699983932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 874",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584020874",
            "telephone_number": "701-252-5398",
            "fax_number": "701-952-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 2ND AVE NE",
            "address_2": "SUITE 221",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013373",
            "telephone_number": "701-252-5398",
            "fax_number": "701-252-5398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBRA I.PETERSON PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "IRENE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "701-252-5398",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12115",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; 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.