MR. RUSSELL HENRY PETERSON M.S.
NPI 1093879637
Counselor - Mental Health in Idaho Falls, ID

Q: What is Russell Peterson's NPI number?

The NPI number for Russell Peterson is 1093879637. It was assigned to this individual provider in the NPPES registry on December 20, 2006.

Q: What is Russell Peterson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Russell Peterson was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since December 20, 2006PECOS EnrolledAccepts Medicare Assignment

2375 E SUNNYSIDE RD, SUITE C, IDAHO FALLS, ID 83404(208) 529-5777(208) 529-5778 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

On this page

About Mr. Russell Henry Peterson M.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. RUSSELL HENRY PETERSON M.S. (NPI 1093879637) is an individual mental health provider in Idaho Falls, Idaho, licensed in Idaho (LCPC-3125) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1997).

NPPES Registry Identity

NPI1093879637

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameMR. RUSSELL HENRY PETERSONCredential: M.S.

Location Address2375 E SUNNYSIDE RD, SUITE CIdaho Falls, ID 83404-8280

Mailing Address4360 E 278 NRigby, ID 83442-5892 · (208) 359-4775 · Fax (208) 356-5461

Phone(208) 529-5777

Fax(208) 529-5778

Sole ProprietorNo

Medical School CMSOtherGraduated 1997

Enumeration DateDecember 20, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1093879637 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in ID · LCPC-3125

2375 E SUNNYSIDE RD, Idaho Falls, ID 83404

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Russell Henry Peterson M.s. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6204270978

PECOS Enrollment IDI20240221001874

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CATHERINE L. LINDERMAN MD PLLC

Clinic/Center (Pain)

2375 E SUNNYSIDE RD, SUITE A
IDAHO FALLS, ID 83404

Bonneville County (208) 524-0610

CATHERINE L LINDERMAN MD

Clinic/Center (Pain)

2375 E SUNNYSIDE RD
IDAHO FALLS, ID 83404

Bonneville County (208) 524-0610

CREEKSIDE SURGERY CENTER LLC

Clinic/Center (Ambulatory Surgical)

2375 E SUNNYSIDE RD, SUITE B
IDAHO FALLS, ID 83404

Bonneville County (208) 524-0610

MS. CATHY S KOTTER LPC

Counselor (Mental Health)

2375 E SUNNYSIDE RD, SUITE C
IDAHO FALLS, ID 83404

Bonneville County (208) 529-5777

GRACIE ANN HARGRAVES ED.D, LCPC

Counselor (Mental Health)

2375 E SUNNYSIDE RD, SUITE C
IDAHO FALLS, ID 83404

Bonneville County (208) 529-5777

STEPHEN R MARANO MD PC

Neurological Surgery

2375 E SUNNYSIDE RD, STE F
IDAHO FALLS, ID 83404

Bonneville County (208) 522-6930

BMH, INC.

Anesthesiology (Pain Medicine)

2375 E SUNNYSIDE RD
IDAHO FALLS, ID 83404

Bonneville County (208) 785-4100

MR. STEVEB JOHN MOODY LPC

Counselor (Professional)

2375 E SUNNYSIDE RD, SUITE C
IDAHO FALLS, ID 83404

Bonneville County (208) 529-5777

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Russell Peterson's NPI number?

The NPI number for Russell Peterson is 1093879637. It was assigned to this individual provider in the NPPES registry on December 20, 2006.

Where is Russell Peterson located?

Russell Peterson practices at 2375 E Sunnyside Rd Suite C, Idaho Falls, ID 83404. The listed phone number is (208) 529-5777.

What is Russell Peterson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Russell Peterson enrolled in Medicare?

Yes. Russell Peterson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Russell Peterson accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 3 other insurers list Russell Peterson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Russell Peterson was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.