IndividualActive
Jerry Petersen, MD
NPI 1467451344 · Family Medicine Physician · Spring Park, MN
Jerry Petersen, MD is a Family Medicine Physician provider in Spring Park, MN (NPI 1467451344).
Provider details
- NPI number
- 1467451344
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 20372 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4695 Shoreline Dr
Spring Park, MN 55384-9715
Phone: (952) 442-7890
Fax: (952) 442-7893
Street-level locationGet directions
Mailing address
4695 Shoreline Dr
Spring Park, MN 55384-9715
Registry dates
- Enumerated
- 2005-07-21
- Last updated
- 2008-05-12
Frequently asked questions
- What is Jerry Petersen's NPI number?
- Jerry Petersen's National Provider Identifier (NPI) is 1467451344, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jerry Petersen's specialty?
- Jerry Petersen is listed in the NPPES registry with a primary specialty of Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Jerry Petersen located?
- Jerry Petersen's practice location on file with NPPES is 4695 Shoreline Dr, Spring Park, MN 55384-9715.
- What is Jerry Petersen's phone number?
- The practice phone number listed in the NPPES registry for Jerry Petersen is (952) 442-7890.
- Is Jerry Petersen's NPI active?
- Yes — Jerry Petersen's NPI (1467451344) is active in the NPPES registry as of the last update on 2008-05-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.