Katherine Moss Pedersen, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01067517A Issued in IN

Practice address

51 N Ford Rd
Zionsville, IN 46077-1233

Phone

(317) 973-3333

NPI assigned

May 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

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.

• St. Vincent Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Winchester, IN
  • NPI 1144513375

  Pediatrics

  Medicare reassignment NPD
• St Vincent Medical Group Inc

  • Cardiovascular Disease Physician
  • Indianapolis, IN
  • NPI 1558686436
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1336359280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N FORD RD",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460771233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N FORD RD",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460771233",
            "telephone_number": "317-973-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "KATHERINE",
        "middle_name": "MOSS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01067517A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "katherine.pedersen.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "51 N Ford Rd",
            "city": "Zionsville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460771233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tammy S. Parker, MA,CCC-SLP
• Manisha Patel, NP
• Caitlin Patterson
• Lauren Olwyn Patterson, LCSW
• Lisa M. Patton, MSW, LCSW, RPT
• Anthony John Pelezo, M.D.
• Molly Jane Pennell, LCSW
• People Helping Other People LLC
• Deborah Anne Pesut, M.A., CCC-SLP
• Jerry D Peyton, MPT

• Pediatrics Physician in Zionsville, IN
• Providers in Zionsville, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.