Physician Compare National (NPI:1952307696)

HEALTHCARE PROVIDER: LINDA R PETERSON MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1952307696
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7113821224
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20031120000857
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PETERSON
	Individual professional last name
Provider First Name	LINDA
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	SANFORD SCHOOL OF MEDICINE OF UNIVERSITY OF SOUTH DAKOTA
	Individual professional's medical school
Graduation Year	1972
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	WOODROW WILSON KEEBLE MEMORIAL HEALTH CARE CENTER
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	1850295940
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	26
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	100 LAKE TRAVERSE DR
	Group Practice or individual's line 1 address
City	SISSETON
	Group Practice or individual's city
State	SD
	Group Practice or individual's state
Zip Code	572627046
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6056987606
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	431339
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	COTEAU DES PRAIRIES HEALTH CARE SYSTEM
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y