Individual provider
JONATHON R PETERSON, PT
CMS NPPES lists JONATHON R PETERSON as an individual provider record with NPI 1003008525. The current record reports a primary practice location in PARK RAPIDS, MN and primary taxonomy code 225100000X.
Type 1 NPIs identify individual healthcare providers. How to read this profile
01
Practice locations
- Primary practice location705 PLEASANT AVE SPARK RAPIDS, MN 564701440
- Additional practice location900 E Broadway AveBismarck, ND 585014520
Only source-designated practice locations are shown here. Mailing addresses are not presented as practice locations.
02
Taxonomy information
225100000XPrimary reported taxonomy
Taxonomy codes describe provider classifications reported to NPPES. Repeated identical codes are shown once, with primary-reported status preserved. They are not licenses, certifications, quality measures, or NPIFolio specialty labels. Read the taxonomy methodology.
03
NPI record information
- NPI status
- Enumerated in NPPES
- Enumeration date
- August 17, 2007
An NPI is a federal identifier. Enumeration and lifecycle information does not establish medical-license status, current practice, disciplinary history, provider quality, or whether a provider is accepting patients.