Pedro T. Salcedo, M.D.,PLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

MD28194 Issued in TN

Legal business name

PEDRO T. SALCEDO, M.D.,PLC

Practice address

311 Landrum PL
Suite 200
Clarksville, TN 37043-6319

Phone

(931) 906-8818

Fax

(931) 906-8898

NPI assigned

Jul 31, 2015

Last updated

Jul 31, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

PEDRO T. SALCEDO,M.D.,PLCAs reported in NPPES

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

Authorized official

Name

Marissa Pulanco Salcedo

Title

Office Manager

Phone

(931) 906-8818

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Pedro T Salcedo MD PLC

Locations

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438300800000",
    "number": "1235515206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3749",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370433749",
            "telephone_number": "931-906-8818",
            "fax_number": "931-906-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 LANDRUM PL",
            "address_2": "SUITE 200",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370436319",
            "telephone_number": "931-906-8818",
            "fax_number": "931-906-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDRO T. SALCEDO, M.D.,PLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEDRO T. SALCEDO,M.D.,PLC",
        "enumeration_date": "2015-07-31",
        "last_updated": "2015-07-31",
        "status": "A",
        "authorized_official_last_name": "SALCEDO",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_middle_name": "PULANCO",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "931-906-8818"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "TN",
            "license": "MD28194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3802904",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rakelia Pearson, RN
• Rebecca Lee Pearson, M.S.
• Donna Jenell Pease, ANP/GNP,BC-ADM,CDE
• Nancy P Pedigo Wilkinson, LMFT
• William Joel Pedigo, MD
• Lastacia Peele
• Brandy Denise Peet
• Katie Greene Pegram, MD
• Trey Amerson Pegram, M.D.
• Emily Pellham

• Point of Service in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Point of Service in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; 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.