NPIMap

Individual provider Active NPI

Laura Elizabeth Pedersen

  • Family Medicine Physician
  • Somerset, KY
National Provider Identifier
1225562010
Registry record updated May 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04600 Issued in KY
Practice address
305 Langdon St
Somerset, KY 42503-2750
Phone
(606) 679-7441
NPI assigned
Apr 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04600 KY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

305 Langdon St
Somerset, KY 42503-2750

Mailing address

1066 White Oak Ave
Maryville, TN 37803-2884
Phone (865) 924-4995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200514001716 KY Practitioner - Family Practice 1951732510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

350 Hospital Way
Suite 100
Somerset, KY 42503-1873
Phone (606) 451-2600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
04600KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Cumberland Regional Hospital LLC CurrentSince Jul 1, 2020 Accepting new patients
Lake Cumberland Regional Hospital, LLC Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Lake Cumberland Regional Hospital LLC Family Medicine Current Accepting new patients
Lake Cumberland Regional Hospital LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

305 Langdon St
Somerset, KY 42503
Phone (606) 451-2994

350 Hospital Way
Ste 100
Somerset, KY 42503
Phone (606) 451-2600

353 Bogle St
Ste A
Somerset, KY 42503
Phone (606) 451-3820

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21269/brand/3/csg/1/fhir/r4
  • Direct secure messaging: laura.pedersen.1@21269.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588982400000",
    "number": "1225562010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1066 WHITE OAK AVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378032884",
            "telephone_number": "865-924-4995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 LANGDON ST",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032750",
            "telephone_number": "606-679-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "LAURA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2020-05-09",
        "certification_date": "2020-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "04600",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

Verify at the official NPI Registry.