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Deactivated NPI 1023178738 Deactivated / Inactive NPI Male Practitioner

Dr. Timothy Lee Peterson , PharmD, RPH

Pharmacist • Saint Peter, MN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Timothy Peterson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 11, 2006
NPI Deactivation Date April 22, 2011
Total Practice Duration ~5 Years of Practice (2006 – 2011)

Professional Overview & Biography Verified Profile Summary

Dr. Timothy Peterson, PharmD, RPH was a registered Pharmacist practicing in Saint Peter, MN. Throughout an active medical career spanning 5 years, Dr. Peterson provided care at the practice location at 612 S MINNESOTA AVE until profile deactivation on 2011-04-22.

Practice Location & Contact Primary Location

Practice Address

612 S Minnesota Ave

Saint Peter, MN 560822100

Telephone 5079315540
Associated Practice Facility / Clinic
🏢 Ericksons Diversified Llc Facility NPI 1952459224

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Saint Peter, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
17 Specialists

Practicing in Saint Peter, MN (4994 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-03-29
Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License MN 116614-7

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Pharmacist

NUCC Taxonomy Code: 183500000X

State License IL 051.040872

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1962153247

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events
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Updated Practice Location March 29, 2026

Registered at 612 S MINNESOTA AVE, SAINT PETER, MN 560822100 (Tel: 5079315540)

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Updated Business Mailing Address March 29, 2026

Registered at 612 S MINNESOTA AVE, SAINT PETER, MN 560822100 (Tel: 5079315540)

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Updated Practice Location September 12, 2025

Registered at 875 E MAIN ST, WACONIA, MN 553871081 (Tel: 9524429334)

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Updated Business Mailing Address September 12, 2025

Registered at 875 E MAIN ST, WACONIA, MN 553871081 (Tel: 9524429334)

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 12, 2025

Pharmacist (License #116614-7 in MN)

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Updated Business Mailing Address September 20, 2024

Registered at 1010 ENTERPRISE DR E, BELLE PLAINE, MN 560112340 (Tel: 9528732605)

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Updated Practice Location July 31, 2015

Registered at 1010 ENTERPRISE DR E, BELLE PLAINE, MN 560112340 (Tel: 9528732605)

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Updated Business Mailing Address July 31, 2015

Registered at 1021 BREEZY CT, WACONIA, MN 553871177

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Provider Name / Credentials Updated July 31, 2015

Recorded as TIMOTHY PETERSON, PHARMD, RPH

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 31, 2015

Pharmacist (License #116614-7 in MN)

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NPI Profile Reactivated July 29, 2015

Record officially reactivated for active practice on July 29, 2015

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NPI Profile Deactivated April 22, 2011

Record deactivated on April 22, 2011

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Initial NPI Registration & Enumeration December 11, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1023178738
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 11, 2006
Last Update: March 29, 2026
Deactivation Date: April 22, 2011
Sole Proprietor: No

Mailing Address

612 S Minnesota Ave

Saint Peter, MN 560822100

Phone: 5079315540

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.