Steven Pederson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

623 Issued in ND

Practice address

720 20TH Ave SW
Minot, ND 58701-6441

Phone

(701) 838-8000

Fax

(701) 838-8444

NPI assigned

Nov 8, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1996

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pederson Chiropractic Clinic PC

  • Chiropractor
  • Minot, ND
  • NPI 1831360635
  Medicare reassignment Authorized official
• Johnson Clinic PC

  • Family Medicine Physician
  • Rugby, ND
  • NPI 1609898600
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063581338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 20TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016441",
            "telephone_number": "701-838-8000",
            "fax_number": "701-838-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 20TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016441",
            "telephone_number": "701-838-8000",
            "fax_number": "701-838-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSON",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10644",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Brian Pearson
• Paul Pearson, D.C.
• Christa Pecoraro
• Pederson Chiropractic Clinic PC
• Rhett Thomas Pederson, DDS
• Cody P Pehrson, M.D.
• Bryghton Leigh Peltier
• Nicole Louise Peltier
• Latarshia Nicole Pendleton
• People First Community Services LLC

• Chiropractor in Minot, ND
• Providers in Minot, ND by specialty
• Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.