Individual provider Active NPI

Joseph T. Pedersen, M.D.

  • Radiation Oncology Physician
  • Pikeville, KY
National Provider Identifier
1417969064
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
34198 Issued in KY
Practice address
911 Bypass Rd
Pikeville, KY 41501-1689
Phone
(606) 218-3500
NPI assigned
Aug 12, 2006
Last updated
Jun 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X MD-067177-L PA
Radiation Oncology Physician 2085R0001X 34198 KY Primary

Addresses

Primary practice location

911 Bypass Rd
Pikeville, KY 41501-1689

Mailing address

PO Box 2917
Pikeville, KY 41502-2917
Phone (606) 218-3500

Other identifiers 2

IdentifierTypeStateIssuer
001765945OtherPAHIGHMARK BLUE CROSS
1013753370001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, KY, SC, LA, NY5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20041117000834 NC Practitioner - Radiation Oncology 5890759914 Reassigns benefits to 1 organization
I20130607000500 KY Practitioner - Radiation Oncology 5890759914 Reassigns benefits to 1 organization
I20251010004003 SC Practitioner - Radiation Oncology 5890759914 Reassigns benefits to 1 organization
I20260605003287 LA Practitioner - Radiation Oncology 5890759914 Reassigns benefits to 1 organization
I20260610001493 NY Practitioner - Radiation Oncology 5890759914

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaufort County Memorial HospitalGroup PAC ID 7810809365, 197 clinicians
Guthrie Medical Group PCGroup PAC ID 6002728656, shared by 5 NPIs, 795 clinicians

Practice addresses (Care Compare)

122 Okatie Ctr Blvd N
Suite 130
Okatie, SC 29909-3782
Phone (843) 522-7800

2 Guthrie Dr
Corning, NY 14830-3697
Phone (607) 937-3100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34198KYMDRadiation Oncology Physician
MD-067177-LPAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Mso LLC Current Accepting new patients
Beaufort County Memorial Hospital Radiation Oncology CurrentSince Jul 21, 2025 Accepting new patients
Watauga Medical Center Inc CurrentSince Dec 23, 2024 Accepting new patients
Watauga Medical Center, Inc. Current Accepting new patients
Kentucky Mso, LLC Radiation Oncology CurrentSince Apr 1, 2024 Accepting new patients
Watauga Medical Center Inc Radiation Oncology CurrentSince Dec 23, 2024 Accepting new patients
Beaufort County Memorial Hospital CurrentSince Jul 21, 2025 Accepting new patients
Kentucky Mso LLC CurrentSince Apr 1, 2024 Accepting new patients
Beaufort County Memorial Hospital Past Accepting new patients
Ahoskie Imaging LLC Radiation Oncology Past Accepting new patients
Radiation Services of North Carolina LLC Radiation Oncology Past Accepting new patients
East Carolina Health Past Accepting new patients

Locations

1140 Lexington Rd
Georgetown, KY 40324
Phone (502) 868-1100

1152 Lexington Rd
Georgetown, KY 40324
Phone (502) 570-4003

155 Furman Rd
Ste 101
Boone, NC 28607
Phone (828) 262-4111

336 Deerfield Rd
Boone, NC 28607
Phone (828) 263-1211

338 Deerfield Rd
Boone, NC 28607
Phone (828) 263-1211

989 Ribaut Rd
Beaufort, SC 29902
Phone (843) 522-5900

989 Ribaut Rd
Ste 130
Beaufort, SC 29902
Phone (843) 522-7800

122 Okatie Center Blvd N
Ste 130
Okatie, SC 29909
Phone (843) 273-7980

Interoperability endpoints

  • Direct secure messaging: joseph.pedersen.1@16436.direct.athenahealth.com
  • Direct secure messaging: joseph.pedersen.1@19475.direct.athenahealth.com
  • Direct secure messaging: jpedersen@direct.mhg.com
  • Direct secure messaging: jpedersen1178850@direct.unc.nchie.net
  • Direct secure messaging: jpedersen580293@directb.mercy.net

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1417969064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2917",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415022917",
            "telephone_number": "606-218-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 BYPASS RD",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011689",
            "telephone_number": "606-218-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "JOSEPH",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "PA",
            "license": "MD-067177-L",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "KY",
            "license": "34198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE CROSS",
            "identifier": "001765945",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013753370001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikeville, KY

Sources for this page

Verify at the official NPI Registry.