McKenzie Reile Peterson, DNP, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R36156 Issued in ND

Practice address

705 E Main Ave
Bismarck, ND 58501-4525

Phone

(701) 502-4669

Fax

(833) 608-1015

NPI assigned

May 31, 2017

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

Other names 1

• Mick Peterson Other name

Medicare fee-for-service enrollment

Enrolled in ND, MN2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sanford Medical Center Bismarck Hospital, Bismarck, ND, CCN 350015
• CHI St Alexius Health Hospital, Bismarck, ND, CCN 350002

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: healthnow.mckenziepeterson@150441.advancedmd-direct.com

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.

• Phoenix Health Enterprises PLLC

  • Primary Care Clinic/Center
  • Bismarck, ND
  • NPI 1730856253

  MN

  Medicare reassignment NPD Authorized official
• Vibra Physicians LLC

  • Hospitalist Physician
  • Johnstown, CO
  • NPI 1659705424

  ND

  Medicare reassignment NPD

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

• Sanford Bismarck

  • General Acute Care Hospital
  • Bismarck, ND
  • NPI 1538245634
  Care Compare affiliation
• St. Alexius Medical Center

  • General Acute Care Hospital
  • Bismarck, ND
  • NPI 1306832654
  Care Compare affiliation

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1922536267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7433",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585077433",
            "telephone_number": "701-226-7586",
            "fax_number": "833-608-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 E MAIN AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014525",
            "telephone_number": "701-502-4669",
            "fax_number": "833-608-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MCKENZIE",
        "middle_name": "REILE",
        "credential": "DNP, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-31",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R36156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICK",
            "last_name": "PETERSON",
            "credential": "DNP, APRN, FNP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Chase Peterson
• Douglas Peterson, M.D.
• Emma Peterson, SLP
• Jennifer Peterson, PT, DPT, WCC
• Marcia Peterson
• Melinda Peterson
• Monica Peterson
• Morgan Peterson
• Peggy J.M. Peterson, PTA/L
• Peter C Peterson, PHD

• Family Nurse Practitioner in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Family Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; 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.