Harold W Pedersen, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R 066992-0 Issued in MN

Practice address

8990 Springbrook Dr NW
Ste 250
Coon Rapids, MN 55433-5850

Phone

(763) 398-0099

Fax

(763) 398-0124

NPI assigned

Aug 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210896000000",
    "number": "1255323200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 8TH ST NE",
            "address_2": "APT 101",
            "city": "MILACA",
            "state": "MN",
            "postal_code": "563531678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8990 SPRINGBROOK DR NW",
            "address_2": "STE 250",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335850",
            "telephone_number": "763-398-0099",
            "fax_number": "763-398-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "HAROLD",
        "middle_name": "W",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2008-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R 066992-0",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMN",
            "identifier": "94D43PE",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "696742600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• PDG,P.a.
• PDR Coon Rapids, Inc
• Amanda Pearson
• Christine A. Pearson, P.T.
• Carter M Peatross, MD
• Chelsea Pederson
• People Incorporated
• Isabel Pereira, D.O.
• Rachel Marie Perri
• Daniel Lawrence Perron, RN

• Certified Registered Nurse Anesthetist in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Certified Registered Nurse Anesthetist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; 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.