Katie Rebecca Peterson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11934 Issued in MN

Practice address

111 W Vernon Ave
Fergus Falls, MN 56537-2741

Phone

(218) 736-8000

NPI assigned

Aug 6, 2024

Last updated

Aug 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prairie Ridge Hospital and Health ServicesGroup PAC ID 0648222349, 90 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prairie Ridge Hospital and Health Services Hospital, Elbow Lake, MN, CCN 241379
• Lake Region Healthcare Corporation Hospital, Fergus Falls, MN, CCN 240052

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/

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.

• Lake Region Healthcare Corporation

  dba Lake Region Healthcare

  • Critical Access Hospital
  • Elbow Lake, MN
  • NPI 1407838329
  Medicare reassignment Care Compare group
• Lake Region Healthcare Corporation

  • General Acute Care Hospital
  • Fergus Falls, MN
  • NPI 1093713372
  NPD
• Lake Region Healthcare Corporation

  • Chiropractor
  • Fergus Falls, MN
  • NPI 1265148480
  NPD
• Lake Region Healthcare Corporation

  dba Lake Region Healthcare

  • Critical Access Hospital
  • Fergus Falls, MN
  • NPI 1285525436
  NPD
• Lake Region Healthcare Corporation

  dba Lake Region Healthcare

  • Durable Medical Equipment & Medical Supplies
  • Fergus Falls, MN
  • NPI 1942191119
  NPD
• Lutheran Brethren Home Health Services, Inc.

  dba LB Home Care

  • Home Health Agency
  • Fergus Falls, MN
  • NPI 1831460484
  NPD
• Lake Region Healthcare Corporation

  dba Lake Region Healthcare

  • Chiropractor
  • Fergus Falls, MN
  • NPI 1568353738
  NPD (past)

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

• Lake Region Healthcare Corporation

  dba Lake Region Healthcare

  • Critical Access Hospital
  • Fergus Falls, MN
  • NPI 1285525436
  Care Compare affiliation
• Lake Region Healthcare Corporation

  dba Lake Region Healthcare

  • Critical Access Hospital
  • Elbow Lake, MN
  • NPI 1407838329
  Care Compare affiliation

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

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1720818677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 W LINDEN ST",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565371047",
            "telephone_number": "218-205-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W VERNON AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372741",
            "telephone_number": "218-736-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KATIE",
        "middle_name": "REBECCA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "11934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Perrier
• Emily Petersen
• Joseph John Petersen
• Erin Lee Peterson, MD
• Gregory James Peterson, M.D.
• Nicole Diane Peterson, LPN
• Orlo William Pettit, MD
• Brian Keith Pickering, ATC
• Amy Carol Piechowski, RDH
• Karla Mae Piechowski, RN PHN

• Family Nurse Practitioner in Fergus Falls, MN
• Providers in Fergus Falls, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.