| Peterson Medical Clinics, Llc | |
|
3674 S Washington St Grand Forks ND 58201-5766 | |
| (701) 205-3000 | |
| (701) 732-2501 |
| Full Name | Peterson Medical Clinics, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3674 S Washington St, Grand Forks, North Dakota |
| Authorized Official Name and Position | Thomas M Peterson (OWNER) |
| Authorized Official Contact | 7012053000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peterson Medical Clinics, Llc Po Box 5210 Grand Forks ND 58206-5210 Ph: () - | Peterson Medical Clinics, Llc 3674 S Washington St Grand Forks ND 58201-5766 Ph: (701) 205-3000 |
| NPI Number | 1699295774 |
|---|---|
| Provider Enumeration Date | 06/21/2017 |
| Last Update Date | 10/01/2025 |
| Certification Date | 10/01/2025 |
| Medicare PECOS PAC ID | 9335412220 |
|---|---|
| Medicare Enrollment ID | O20170828003640 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699295774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (North Dakota) | Primary |
| Provider Name | Timothy Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134211568 PECOS PAC ID: 9739197567 Enrollment ID: I20060405000101 |
| Provider Name | Kimber Lcsw Osowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982660908 PECOS PAC ID: 5294922563 Enrollment ID: I20101213000556 |
| Provider Name | Thomas Michael Peterson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639131014 PECOS PAC ID: 7911809843 Enrollment ID: I20110122000068 |
| Provider Name | Bradford Frank |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922057074 PECOS PAC ID: 9830130194 Enrollment ID: I20130522000189 |
| Provider Name | Matthew J Pitera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225097702 PECOS PAC ID: 9436111077 Enrollment ID: I20140729000726 |
| Provider Name | Muhammad Azhar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316155534 PECOS PAC ID: 4789876707 Enrollment ID: I20140731000173 |
| Provider Name | Natasha Krebs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659889798 PECOS PAC ID: 0042573743 Enrollment ID: I20180411000753 |
| Provider Name | Ryan Greene |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104231505 PECOS PAC ID: 2668691700 Enrollment ID: I20180604002590 |
| Provider Name | Megan Weddingfeld |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467815266 PECOS PAC ID: 6204176456 Enrollment ID: I20190326000460 |
| Provider Name | Faith Murray-taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942693346 PECOS PAC ID: 4183934110 Enrollment ID: I20190404002406 |
| Provider Name | Courtney Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790347268 PECOS PAC ID: 2062741077 Enrollment ID: I20190916003181 |
| Provider Name | Jennifer Fetsch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134579139 PECOS PAC ID: 0244665644 Enrollment ID: I20200130001698 |
| Provider Name | Charles Morgan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275065922 PECOS PAC ID: 8426461047 Enrollment ID: I20201228002039 |
| Provider Name | Bailey Alvarez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912444936 PECOS PAC ID: 0042642647 Enrollment ID: I20210726001422 |
| Provider Name | Stephan Becker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063678795 PECOS PAC ID: 2062660921 Enrollment ID: I20220325000304 |
| Provider Name | Kristen Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629679782 PECOS PAC ID: 6608275284 Enrollment ID: I20221013003322 |
| Provider Name | Dolores Van Bourgondien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457788390 PECOS PAC ID: 9032332275 Enrollment ID: I20230512002370 |
| Provider Name | Rebecca Ohlson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043793920 PECOS PAC ID: 6901263367 Enrollment ID: I20230531001862 |
| Provider Name | Stephanie Tubbs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396444071 PECOS PAC ID: 8527424597 Enrollment ID: I20230601002254 |
| Provider Name | Jasmine Allen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508587411 PECOS PAC ID: 3274999321 Enrollment ID: I20230614000610 |
| Provider Name | Jordyn Lindaman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528780350 PECOS PAC ID: 1658730270 Enrollment ID: I20230629002650 |
| Provider Name | Anne Chambers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427718428 PECOS PAC ID: 8022475193 Enrollment ID: I20230814001688 |
| Provider Name | Kaylob Candey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811588353 PECOS PAC ID: 4486018660 Enrollment ID: I20230927004083 |
| Provider Name | Nicole Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932122587 PECOS PAC ID: 8820902869 Enrollment ID: I20231129002128 |
| Provider Name | Gwen Cedfeldt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053947796 PECOS PAC ID: 0244689511 Enrollment ID: I20231212001789 |
| Provider Name | Elle White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376299636 PECOS PAC ID: 6901255280 Enrollment ID: I20231212002134 |
| Provider Name | Lindsey Marie Johanning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649055195 PECOS PAC ID: 5395192314 Enrollment ID: I20231220001234 |
| Provider Name | Sarah Ashley Huffstetler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295224442 PECOS PAC ID: 8325498090 Enrollment ID: I20231222001324 |
| Provider Name | Angela Kaiser |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134766561 PECOS PAC ID: 6901256080 Enrollment ID: I20240102002934 |
| Provider Name | Cheryl Repp-tredway |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073990800 PECOS PAC ID: 9537519624 Enrollment ID: I20240102003355 |
| Provider Name | Kenneth Hodem |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770173817 PECOS PAC ID: 1850744418 Enrollment ID: I20240130003416 |
| Provider Name | Verena Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689397184 PECOS PAC ID: 5395113450 Enrollment ID: I20240130003626 |
| Provider Name | Kerste De Coteau |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104227644 PECOS PAC ID: 9436692993 Enrollment ID: I20240625002210 |
| Provider Name | Deonna K Spies |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528810496 PECOS PAC ID: 1456895390 Enrollment ID: I20240702001722 |
| Provider Name | Emelia Conaty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144078486 PECOS PAC ID: 1052859139 Enrollment ID: I20240820003938 |
| Provider Name | Orunor Esin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902647183 PECOS PAC ID: 0042756686 Enrollment ID: I20240821003008 |
| Provider Name | Miles Ardaman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831142702 PECOS PAC ID: 1355364688 Enrollment ID: I20240903004343 |
| Provider Name | Grace Capozzelli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275203119 PECOS PAC ID: 0143769505 Enrollment ID: I20240905001142 |
| Provider Name | Brandi Embacher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922352426 PECOS PAC ID: 0749721710 Enrollment ID: I20240917004460 |
| Provider Name | Lindsay G Erdmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245707272 PECOS PAC ID: 0941547004 Enrollment ID: I20241008004067 |
| Provider Name | Gerard Dickmu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780419812 PECOS PAC ID: 6002347515 Enrollment ID: I20241010002819 |
| Provider Name | Mary Mccurdy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962839969 PECOS PAC ID: 4688106057 Enrollment ID: I20241024004011 |
| Provider Name | Kimberly Shamakian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871325563 PECOS PAC ID: 7911431879 Enrollment ID: I20241121004427 |
| Provider Name | Linda Boothe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912931502 PECOS PAC ID: 9931104304 Enrollment ID: I20241126003355 |
| Provider Name | Andrina Lee Brantley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104564293 PECOS PAC ID: 7416485859 Enrollment ID: I20250219002302 |
| Provider Name | Pamela Huckaby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750679122 PECOS PAC ID: 3577821271 Enrollment ID: I20250321003197 |
| Provider Name | Bethany Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942847868 PECOS PAC ID: 0840627345 Enrollment ID: I20250321003342 |
| Provider Name | Kayleigh Laiche |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184250714 PECOS PAC ID: 3577099043 Enrollment ID: I20250327002566 |
| Provider Name | Vanessa Delgado-ramirez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518246925 PECOS PAC ID: 6002236262 Enrollment ID: I20250422000697 |
| Provider Name | Brittni Gallup |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740083849 PECOS PAC ID: 5698291722 Enrollment ID: I20250502002701 |
| Provider Name | Kara Lorraine Dickinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609679430 PECOS PAC ID: 8527585173 Enrollment ID: I20250507000713 |
| Provider Name | Rebecca Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801150446 PECOS PAC ID: 6608230982 Enrollment ID: I20250603000059 |
Stage Of Change Therapy Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 4200 James Dr # 305, Grand Forks, ND 58202 Phone: 701-213-6999 | |
Family Institute, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2100 S Columbia Rd, Suite 202, Grand Forks, ND 58201 Phone: 701-772-1588 Fax: 701-746-6077 | |
You Shine Too Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 215 S 4th St, Grand Forks, ND 58201 Phone: 701-787-1295 | |
Center For Psychiatric Care Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1451 44th Ave S, Unit A, Grand Forks, ND 58201 Phone: 701-732-2500 Fax: 701-732-2501 | |
Lipp, Carlson, Witucki & Associates, Ltd Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2808 17th Ave S, Grand Forks, ND 58201 Phone: 701-746-8376 Fax: 701-746-9872 | |
Cambian Behavioral Health Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1407 24th Ave S, Grand Forks, ND 58201 Phone: 701-213-9993 | |
Woodnote Therapy Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1913 S Washington St, Grand Forks, ND 58201 Phone: 701-317-6590 |