William R Pedersen

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

WILLIAM R PEDERSEN

Practice address

730 West Lamar Alexander Pkwy
Maryville, TN 37801

Phone

(865) 982-2020

Fax

(865) 970-2020

NPI assigned

Mar 3, 2008

Organization subpart

No

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

Authorized official

Name

William R Pedersen, OD

Title

Owner

Phone

(865) 982-2020

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1063682383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 WEST LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "37801",
            "telephone_number": "865-982-2020",
            "fax_number": "865-970-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 WEST LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "37801",
            "telephone_number": "865-982-2020",
            "fax_number": "865-970-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM R PEDERSEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "PEDERSEN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "865-982-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Gail White, APN
• Caitlin Reeves Whitehead, PTA
• Kristina Michelle Whitson, FNP-BC
• Mark M. Widloski, DDS
• Hollie Wilder, BS
• Charles Richard Williams, DC
• Crystal Christine Williams, APN
• Jesse Williams
• Robert Lee Williams, LCSW
• Robert W Williams, APRN

• Optometrist in Maryville, TN
• Providers in Maryville, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.

Verify at the official NPI Registry.