Individual provider Active NPI

Sherrie Peterson, RN-BC

  • Addiction (Substance Use Disorder) Registered Nurse
  • Fargo, ND
National Provider Identifier
1922463462
Registry record updated Dec 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
R20492 Issued in ND
Practice address
4227 9TH Ave S
Fargo, ND 58103-2018
Phone
(701) 282-6561
NPI assigned
Dec 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X R20492 ND Primary

Addresses

Primary practice location

4227 9TH Ave S
Fargo, ND 58103-2018

Mailing address

4227 9TH Ave S
Fargo, ND 58103-2018
Phone (701) 282-6561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R20492NDMDAddiction (Substance Use Disorder) Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1922463462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4227 9TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032018",
            "telephone_number": "701-282-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4227 9TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032018",
            "telephone_number": "701-282-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SHERRIE",
        "credential": "RN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-29",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "R20492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; 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.