William Pederson, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

D3364 Issued in TX

Practice address

500 Thompson Dr
Kerrville, TX 78028-5144

Phone

(830) 257-6553

Fax

(830) 896-4448

NPI assigned

Apr 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Health and Human Services Commission

  • Clinical Neuropsychologist
  • Harlingen, TX
  • NPI 1356414692

  Psychiatry

  Medicare reassignment NPD
• Health and Human Services Commission

  • Psychiatric Hospital
  • Big Spring, TX
  • NPI 1881600682
  NPD

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1295952364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 WATER ST",
            "address_2": "SUITE 300",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285333",
            "telephone_number": "830-792-3300",
            "fax_number": "830-792-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 THOMPSON DR",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285144",
            "telephone_number": "830-257-6553",
            "fax_number": "830-896-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSON",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "TX",
            "license": "D3364",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "D3364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunny N. Pawlik, LCDC
• Karen Sue Payne, LVN
• Lauren Payne
• Salvador A Payumo Jr., PMHNP
• Corinne Mary Pederson, D.C.
• Kelly C Pelton, MD
• Pena Optical Solutions LLC
• Benito Pena, O.D
• Pepper Pediatrics Therapy & Consulting, LLC
• Pamela Morris Peter, LPC, LCDC

• Psychiatry Physician in Kerrville, TX
• Providers in Kerrville, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.