Ann Pedack

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP60497917 Issued in WA

Practice address

715 9TH Ave
Seattle, WA 98104-2066

Phone

(206) 902-4582

NPI assigned

Aug 26, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Miranova Health PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Seattle, WA
  • NPI 1932730447
  NPD

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1215337399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 37TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981262106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042066",
            "telephone_number": "206-902-4582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDACK",
        "first_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP60497917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie A Peck, DO
• Rachel E Peck, DPT
• Rikki Peck
• Scott Richard Peck, D.D.S.
• Emma Peconga
• Patricia Lynn Pedegana
• Amanda L Pedersen, PA-C
• Craig A Pedersen, RPH, PHD
• Railey K Pedersen, CMA
• Stephanie Pedersen, DDS

• Adult Health Nurse Practitioner in Seattle, WA
• Providers in Seattle, WA by specialty
• Adult Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.