Active NPI
Rick Wayne Peters, LADC
- Addiction (Substance Use Disorder) Counselor
- Baxter, MN
National Provider Identifier
1942432075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 302318
- Practice address
- 13045 Falcon Dr
Suite 100
Baxter, MN 56425-4201 - Phone
- (218) 829-9307
- Fax
- (218) 829-7649
- NPI assigned
- Aug 24, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 302318 | MN | Primary |
Addresses
Primary practice location
13045 Falcon Dr
Suite 100
Baxter, MN 56425-4201
Mailing address
1900 Silver Lake NWRD 110
New Brighton, MN 55112
Phone (651) 379-1718
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
| License | State | Type | Specialty |
|---|---|---|---|
| 302318 | MN | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430697600000",
"number": "1942432075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 SILVER LAKE NWRD 110",
"city": "NEW BRIGHTON",
"state": "MN",
"postal_code": "55112",
"telephone_number": "651-379-1718",
"fax_number": "651-379-1738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13045 FALCON DR",
"address_2": "SUITE 100",
"city": "BAXTER",
"state": "MN",
"postal_code": "564254201",
"telephone_number": "218-829-9307",
"fax_number": "218-829-7649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "RICK",
"middle_name": "WAYNE",
"name_prefix": "Mr.",
"credential": "LADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-08-24",
"last_updated": "2015-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "302318",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baxter, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.