NPIMap

Organization Active NPI

Betsy Pedersen PHD PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Durham, NC
National Provider Identifier
1346665882
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
1808 Issued in NC
Legal business name
BETSY PEDERSEN PHD PC
Practice address
1502 W NC Highway 54
Suite 603
Durham, NC 27707-5571
Phone
(919) 923-3278
Fax
(919) 419-3110
NPI assigned
Feb 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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

Authorized official

Name
Dr. Elizabeth R Pedersen, PHD
Title
President
Phone
(919) 923-3278

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 1808 NC Primary

Addresses

Primary practice location

1502 W NC Highway 54
Suite 603
Durham, NC 27707-5571

Mailing address

1502 W NC Highway 54
Suite 603
Durham, NC 27707-5571
Phone (919) 923-3278

Other identifiers 3

IdentifierTypeStateIssuer
2815321BOtherNCMEDICARE PTAN
1808OtherNCPRACTICE LICENSE -PSYCHOLOGIST
60008531DMedicaidNC

National Provider Directory

National Provider Directory

Locations

1502 W NC Highway 54
Ste 603
Durham, NC 27707
Phone (919) 419-3110

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392854400000",
    "number": "1346665882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 W NC HIGHWAY 54",
            "address_2": "SUITE 603",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075571",
            "telephone_number": "919-923-3278",
            "fax_number": "919-419-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 W NC HIGHWAY 54",
            "address_2": "SUITE 603",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075571",
            "telephone_number": "919-923-3278",
            "fax_number": "919-419-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETSY PEDERSEN PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-20",
        "last_updated": "2014-02-20",
        "status": "A",
        "authorized_official_last_name": "PEDERSEN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-923-3278",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NC",
            "license": "1808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2815321B",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE LICENSE -PSYCHOLOGIST",
            "identifier": "1808",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60008531D",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; 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.