Jerry R. Petersen, MD
Family Medicine Physician · Spring Park, MN
Jerry R. Petersen, MD is a family medicine physician with a practice address in Spring Park, Minnesota, and NPI 1467451344, issued on Jul 21, 2005. Check the license (Minnesota 20372, as entered in NPPES) on the Minnesota Board of Medical Practice; the federal record below is the public data PlainDoctor holds for this provider.
- Name
- Jerry R. Petersen
- Credential
- MD
- Primary taxonomy
- Family Medicine Physician 207Q00000X
- License number
- 20372 MN
Self-reported in NPPES; status is on the state search - Practice location
- 4695 Shoreline Dr, Spring Park, MN 55384
- Phone
- (952) 442-7890
- Enumerated
- Jul 21, 2005
- Record last updated
- May 12, 2008 (not updated in 18 years: call before relying on the address or phone)
- Fax
- (952) 442-7893
- Medicaid ID
- 5093724700 MO
- Entity
- Type 1 · individual
Also registered at 4695 Shoreline Dr
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Julie Dejong, M.D.Family Medicine Physician1023277837
- James Lehmann, MDInternal Medicine Physician1083743645
- Judith Miller, MDGerontology Nurse Practitioner1306845243
- Eric Nagle, MDInternal Medicine Physician1902855539
- Steven Nerheim, M.D.Family Medicine Physician1255351342
- Jennifer RyssoInternal Medicine Physician1033195813
Verify Jerry R. Petersen in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersMinnesota Board of Medical Practice
Search for license 20372Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
5 family medicine physician records list a practice address in Spring Park
They are 5 of the 25 NPPES records with a practice address in Spring Park, and 3,985 family medicine physician records in Minnesota. No Medicare prescribing, quality score, industry payment or hospital affiliation is published for this NPI.
All 5 in Spring Park → All 3,985 in Minnesota → Every provider in Spring Park →
Other family medicine physician records in Minnesota
- Allison AaseMinneapolis, MN1255028239
- Lise Aasheim, M.D.Albert Lea, MN1871571851
- Cherry Abary, D.O.Eden Prairie, MN1821019712
- Jihan Abbott, D.O.Woodbury, MN1306138870
- Andrea Abcejo, MDByron, MN1700143153
- Mona Abdel-Bary, MBBCHFridley, MN1689067860
- Yasmin Abdulaya, MDSaint Cloud, MN1437892536
- Bangean Abdullah, MDCoon Rapids, MN1952363137
- Ryan Aberle, MDRobbinsdale, MN1639732928
- Gregory Abler, MDMorris, MN1609889740
Common questions
What is Jerry R. Petersen, MD's NPI number?
Jerry R. Petersen, MD's National Provider Identifier (NPI) is 1467451344, issued on Jul 21, 2005. An NPI identifies a provider in billing; it is not a license.
Where is Jerry R. Petersen, MD located?
The NPPES record lists a practice address at 4695 Shoreline Dr, Spring Park, MN, 55384. Phone: (952) 442-7890. Providers update this record themselves, so call before visiting.
How can I verify Jerry R. Petersen, MD's license?
NPPES lists Minnesota license number 20372, as entered by the provider. Search the Minnesota Board of Medical Practice at https://mn.gov/boards/medical-practice/. The NPPES record confirms identity only; the state search shows license status, expiration and public orders.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.