JERRY R PETERSEN (MD) – Family Medicine Physician, NPI 1467451344

JERRY R PETERSEN (MD) is a healthcare provider. based in Spring park, Minnesota. specializing in Family Medicine Physician. They hold the professional credentials MD. They hold a License No. 20372 (MN). The NPI Number for JERRY R PETERSEN (MD) is 1467451344

Main info

Male
Name
JERRY R PETERSEN (MD)
NPI
1467451344
Phone
(952) 442-7890
Address
4695 SHORELINE DR
Enumeration Date
21 July 2005
Last Update Date
12 May 2008
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for JERRY R PETERSEN (MD)

  • 4695, Shoreline Drive, Spring Park, Hennepin County, Minnesota, 55384, United States

    SPRING PARK, MN 553849715

    Phone: (952) 442-7890

    Fax: (952) 442-7893

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55384)

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Reviews

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Frequently asked questions

What NPI should I save for JERRY R PETERSEN (MD)?
Save NPI 1467451344 if you need a stable reference for JERRY R PETERSEN (MD).
Is JERRY R PETERSEN (MD)'s NPI currently valid?
The extract we use shows JERRY R PETERSEN (MD) as active.
What does JERRY R PETERSEN (MD) treat or focus on?
Patients typically see JERRY R PETERSEN (MD) under the specialty Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is JERRY R PETERSEN (MD)'s primary listing?
We display Spring Park, Minnesota because that is what the record indicates for JERRY R PETERSEN (MD).
How can I contact JERRY R PETERSEN (MD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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