Active NPI
Linda Joyce Pedersen, PT
- Physical Therapist
- Avon, IN
National Provider Identifier
1033379730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05008449A
- Practice address
- 1111 Ronald Reagan Pkwy
Suite Mg214
Avon, IN 46123-7085 - Phone
- (317) 217-3070
- NPI assigned
- Jun 16, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05008449A | IN | Primary |
Addresses
Primary practice location
1111 Ronald Reagan Pkwy
Suite Mg214
Avon, IN 46123-7085
Mailing address
3673 Meadowlark LN
Brownsburg, IN 46112-8040
Phone (317) 858-4739
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05008449A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213574400000",
"number": "1033379730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3673 MEADOWLARK LN",
"city": "BROWNSBURG",
"state": "IN",
"postal_code": "461128040",
"telephone_number": "317-858-4739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 RONALD REAGAN PKWY",
"address_2": "SUITE MG214",
"city": "AVON",
"state": "IN",
"postal_code": "461237085",
"telephone_number": "317-217-3070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDERSEN",
"first_name": "LINDA",
"middle_name": "JOYCE",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-16",
"last_updated": "2008-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05008449A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.