Individual provider Active NPI

Christopher J Peterson, CRNA

  • Certified Registered Nurse Anesthetist
  • Coon Rapids, MN
National Provider Identifier
1871551960
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
6678 Issued in NC
Practice address
8990 Springbrook Dr NW
Coon Rapids, MN 55433-5850
Phone
(763) 398-0099
Fax
(763) 398-0124
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R 141490-9 MN
Certified Registered Nurse Anesthetist 367500000X 6678 NC Primary

Addresses

Primary practice location

8990 Springbrook Dr NW
Coon Rapids, MN 55433-5850

Mailing address

7455 Fern CT
Loretto, MN 55357-4713
Phone (763) 498-7615

Other identifiers 1

IdentifierTypeStateIssuer
538381100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210727000489 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688689086 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke University Health System, IncGroup PAC ID 2567372345, 1,083 clinicians

Practice addresses (Care Compare)

2400 Pratt St
Durham, NC 27705-3976
Phone (919) 668-1002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
29MNMDClinical Social Worker
6678NCMDSpeech-Language Pathologist
R 141490-9MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Sep 1, 2021 Accepting new patients
Duke University Health System, Inc. Nurse Anesthetist, Certified Registered Current Accepting new patients
Duke University Health System, Inc. CurrentSince Oct 11, 2021 Accepting new patients
East Carolina Anesthesia Associates, PLLC Anesthesiology CurrentSince Sep 1, 2021 Accepting new patients
Raleigh Sedation Associates LLC Anesthesiology CurrentSince Jul 1, 2021 Accepting new patients
Duke University Health System, Inc. CurrentSince Oct 11, 2021 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Sep 1, 2021 Accepting new patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients

Locations

1505 SW Cary Pkwy
Ste 202
Cary, NC 27511
Phone (919) 249-5087

1505 SW Cary Pkwy
Ste 100
Cary, NC 27511
Phone (919) 415-1360

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

2400 Pratt St
Durham, NC 27705
Phone (919) 668-1002

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

2417 Atrium Dr
Ste 101
Raleigh, NC 27607
Phone (919) 249-5216

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

8300 Health Park
Ste 210
Raleigh, NC 27615
Phone (919) 249-5902

3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1871551960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7455 FERN CT",
            "city": "LORETTO",
            "state": "MN",
            "postal_code": "553574713",
            "telephone_number": "763-498-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8990 SPRINGBROOK DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335850",
            "telephone_number": "763-398-0099",
            "fax_number": "763-398-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R 141490-9",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "6678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "538381100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.