Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shannon Nicole Peterson

Individual provider Physician Assistant · NPI 1215690177

Shannon Nicole Peterson is a Physician Assistant in Robbinsdale, Minnesota. Qualified in 2022, 4 years ago. Practices with North Memorial Health Care, a 506-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
4
Licensed in
MN
In the registry since
2021
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Practice location Address checks out

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone: (763) 520-5200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 14422 (MN)

Record details

NPI number1215690177
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 18, 2021
Last updated in NPPESJuly 12, 2023
Certification dateJuly 12, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice North Memorial Health Care — 506 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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