Active NPI
Brenda K. Pedersen, BSOT, OTR/L, CHT
- Occupational Therapist
- Des Moines, IA
National Provider Identifier
1104105303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 00558
- Practice address
- 1212 Pleasant St
Suite 300
Des Moines, IA 50309-1414 - Phone
- (515) 471-9292
- NPI assigned
- Aug 5, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 00558 | IA | Primary |
| Hand Occupational Therapist | 225XH1200X | 9911000064 | CA |
Addresses
Primary practice location
1212 Pleasant St
Suite 300
Des Moines, IA 50309-1414
Mailing address
1212 Pleasant St
Suite 300
Des Moines, IA 50309-1414
Phone (515) 471-9292
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9911000064 | CA | MD | Hand Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312502400000",
"number": "1104105303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1212 PLEASANT ST",
"address_2": "SUITE 300",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503091414",
"telephone_number": "515-471-9292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 PLEASANT ST",
"address_2": "SUITE 300",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503091414",
"telephone_number": "515-471-9292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDERSEN",
"first_name": "BRENDA",
"middle_name": "K.",
"credential": "BSOT, OTR/L, CHT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-05",
"last_updated": "2011-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IA",
"license": "00558",
"primary": true
},
{
"code": "225XH1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Hand",
"state": "CA",
"license": "9911000064",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
- Amy J Pearson, PT
- Bryan Theodore Pearson, MD
- Lisa Marie Pearson
- Carolyn Su-Ying Pease, M.D.
- Caitlin Siobhan Pedati
- Pediatric & Adult Allergy PC
- Pediatric Cardiology, P.C.
- Pediatric Dentistry of Central Iowa, P.C. (Pediatric Dentistry)
- Pediatrics and Adolescent Medicine, P.C.
- Alissa Marie Peer, BS., CADC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.