Pediatric & Adolescent Care of MN., P.a.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

Legal business name

PEDIATRIC & ADOLESCENT CARE OF MN., P.A.

Practice address

1547 Livingston Ave
Saint Paul, MN 55118-3411

Phone

(651) 451-8050

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Carolyn Dreelan

Title

Administrator

Phone

(651) 451-4700

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184796898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1547 LIVINGSTON AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551183411",
            "telephone_number": "651-451-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1547 LIVINGSTON AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551183411",
            "telephone_number": "651-451-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC & ADOLESCENT CARE OF MN., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DREELAN",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "651-451-4700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Pedersen, PHARM.D.
• Cynthia Ann Pedersen, OTR/L, CHT
• Tracy Pedersen, M.S., CCC-SLP
• Melissa Wheelock Pederson, PH.D., L.P.
• Patrick Pederson
• Pediatric Acupuncture and Wellness Center
• Pediatric and Young Adult Medicine, PA
• Pediatric Orthopaedic Associates
• Pediatric Rehabilitation Associates
• Maia Nicole Pedrosa

• Pediatric Adolescent Medicine Physician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Pediatric Adolescent Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.