Anni Pedersen

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

46TR00065700 Issued in NJ

Practice address

500 River Ave
Suite 245
Lakewood, NJ 08701-4738

Phone

(732) 367-1888

NPI assigned

Jan 29, 2010

Last updated

Jan 29, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264723200000",
    "number": "1104157205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 LINCOLN AVE",
            "city": "FAIR HAVEN",
            "state": "NJ",
            "postal_code": "077043050",
            "telephone_number": "732-371-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 RIVER AVE",
            "address_2": "SUITE 245",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014738",
            "telephone_number": "732-367-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "ANNI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-29",
        "last_updated": "2010-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00065700",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC010760",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beatriz C Patino-Sherard, LSW
• Kenneth Pavlinec, PT, CERT. MDT
• Pdi Health NJ LLC
• Pdi Health NJ LLC
• Pearl Braun Speech and Language Services LLC
• Shannon Pedersen
• Pedi-Care Corp (Pedicare Orthotics & Prosthetics)
• Pediapath ABA LLC
• Pediatric OT, LLC.
• Pediatric Speech Associates LLC

• Occupational Therapist in Lakewood, NJ
• Providers in Lakewood, NJ by specialty
• Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; 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.