Individual provider Active NPI

Beth Peterick, NP-C

  • Family Nurse Practitioner
  • Thief River Falls, MN
National Provider Identifier
1720685167
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7808 Issued in MN
Practice address
3001 Sanford Pkwy
Thief River Falls, MN 56701-2700
Phone
(218) 686-2567
NPI assigned
Oct 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7808 MN Primary

Addresses

Primary practice location

3001 Sanford Pkwy
Thief River Falls, MN 56701-2700

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201215003307 MN Practitioner - Nurse Practitioner 4385056340 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Health Network NorthGroup PAC ID 8022206663, shared by 16 NPIs, 114 clinicians

Practice addresses (Care Compare)

1720 Hwy 59 S
Thief River Falls, MN 56701-4331
Phone (218) 681-4747

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.22 of 100Reported as group
Quality
90.28
Promoting interoperability
100
Improvement activities
40
Cost
72.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7808MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network North CurrentSince Nov 9, 2020 Accepting new patients
Sanford Health Network North Current Accepting new patients
Sanford Health Network North CurrentSince Nov 9, 2020 Accepting new patients

Locations

3001 Sanford Pkwy
Thief Rvr Fls, MN 56701
Phone (218) 681-4240

1720 US Highway 59 SE
Thief Rvr Fls, MN 56701
Phone (218) 681-4747

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1720685167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 SANFORD PKWY",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567012700",
            "telephone_number": "218-686-2567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERICK",
        "first_name": "BETH",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "7808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thief River Falls, MN

Sources for this page

Verify at the official NPI Registry.