Individual provider Active NPI

Jane Marie Pedersen, PT

  • Pediatric Physical Therapist
  • Durham, NC
National Provider Identifier
1154371516
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
4397 Issued in NC
Practice address
3000 Erwin Rd
Durham, NC 27705-4504
Phone
(919) 698-2149
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4397 NC
Orthopedic Physical Therapist 2251X0800X 4397 NC
Pediatric Physical Therapist 2251P0200X 4397 NC Primary

Addresses

Primary practice location

3000 Erwin Rd
Durham, NC 27705-4504

Mailing address

308 Hassellwood Dr
Cary, NC 27518-3013
Phone (919) 606-3086

Other practice location 1

1829 E Franklin St Ste 600
Chapel Hill, NC 27514-5863
Phone (919) 968-3456

Other practice location 2

107 Edinburgh South Dr
Ste 100a
Cary, NC 27511-6455
Phone (919) 319-3649

Other practice location 3

308 Hassellwood Dr
Cary, NC 27518
Phone (919) 606-3086

Other identifiers 1

IdentifierTypeStateIssuer
1017POtherBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051118000411 NC Practitioner - Physical Therapist in Private Practice 5890714869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Total Rehabilitation Inc Physical Therapist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1154371516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 HASSELLWOOD DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275183013",
            "telephone_number": "919-606-3086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ERWIN RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054504",
            "telephone_number": "919-698-2149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1829 E Franklin St Ste 600",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275145863",
            "country_code": "US",
            "telephone_number": "919-968-3456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "107 EDINBURGH SOUTH DR",
            "address_2": "STE 100A",
            "address_purpose": "LOCATION",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275116455",
            "country_code": "US",
            "telephone_number": "919-319-3649",
            "fax_number": "919-319-3651",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "308 Hassellwood Dr",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "27518",
            "country_code": "US",
            "telephone_number": "919-606-3086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "JANE",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "4397",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NC",
            "license": "4397",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NC",
            "license": "4397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1017P",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.