OrganizationActive
Peterson Shoe Inc
NPI 1639235088 · Prosthetic/Orthotic Supplier · Anoka, MN
Provider details
- NPI number
- 1639235088
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Michelle Purtle-Smith, Manager(763) 421-3433
- License
- NA (MN)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
209 E Main St
Anoka, MN 55303-3144
Phone: (763) 421-3433
Fax: (763) 421-0054
Street-level locationGet directions
Mailing address
209 E Main St
Anoka, MN 55303-3144
Registry dates
- Enumerated
- 2006-12-29
- Last updated
- 2008-04-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.