Matthew D Peterson, L.AC., DIPL. OM

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

1643 Issued in MN

Practice address

800 E 28TH St
Ste. 404
Minneapolis, MN 55407-3723

Phone

(612) 863-4633

NPI assigned

Feb 19, 2014

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1790100394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-863-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST",
            "address_2": "STE. 404",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MATTHEW",
        "middle_name": "D",
        "credential": "L.AC., DIPL. OM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-19",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "1643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Jane Peterson, CRNA
• Linda Marie Peterson
• Lindsey Peterson, OT
• Louise Ballam Peterson
• Marie Elizabeth Peterson, M.D.
• Meghann Rose Peterson, LICSW
• Michelle D Peterson, DPT, NCS
• Molly Peterson, LICSW
• Nancy Carolyn Peterson, LICSW
• Phillip K Peterson, MD

• Acupuncturist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Acupuncturist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.