Charles L. Pederson, M.D., MPH

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

MD25028 Issued in OR

Practice address

1100 7TH Ave SW
Albany, OR 97321-1925

Phone

(541) 812-5600

NPI assigned

Jun 23, 2006

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Mid-Valley Healthcare Inc

  • Critical Access Hospital
  • Lebanon, OR
  • NPI 1689625980
  Medicare reassignment NPD
• Mid-Valley Healthcare Inc

  • Addiction Medicine (Internal Medicine) Physician
  • Newport, OR
  • NPI 1740087899
  NPD
• Mid-Valley Healthcare, Inc.

  • Rural Health Clinic/Center
  • Sweet Home, OR
  • NPI 1528334125
  NPD
• Firstcare Medical Foundation

  • Family Medicine Physician
  • Albany, OR
  • NPI 1740216498
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1093741803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 7TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211925",
            "telephone_number": "541-812-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSON",
        "first_name": "CHARLES",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D., MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "OR",
            "license": "MD25028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpederson133347@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "1100 7th Ave SW",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachel Maree Patton, RDN CD IBCLC
• Adam B Paul, MD
• Pci Care Venture I, Inc
• Dora Hazen Pearse
• Marie Madonna Peck, OD
• Elina Gouw Pederson, RPH
• Erik Pederson
• Jireh Pejana
• Judith Anne Peltier, RN,MPH
• Elizabeth Penaloza

• Occupational Medicine Physician in Albany, OR
• Providers in Albany, OR by specialty
• Occupational Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.