Jennifer Pedersen, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

CRNA1062 Issued in AZ

Practice address

1850 N Central Ave Ste 1600
Phoenix, AZ 85004-4633

Phone

(602) 262-8900

NPI assigned

Jan 22, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Coronado Anesthesia PLLC

  • Certified Registered Nurse Anesthetist
  • Phoenix, AZ
  • NPI 1336569581

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Sunset Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Mesa, AZ
  • NPI 1841561347

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Valley Anesthesiology Consultants, Inc.

  • Anesthesiology Physician
  • Phoenix, AZ
  • NPI 1285660704
  Medicare reassignment
• East Valley Endoscopy LLC

  • Ambulatory Surgical Clinic/Center
  • Mesa, AZ
  • NPI 1164414447
  NPD (past)

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1497086912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 E MISSOURI AVE",
            "address_2": "STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121351",
            "telephone_number": "602-262-8917",
            "fax_number": "602-262-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 N CENTRAL AVE STE 1600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044633",
            "telephone_number": "602-262-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "JENNIFER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-22",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704275352",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704275352",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "CRNA1062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Robin Peckman, LCSW
• Allison Marie Peckumn, D.O.
• Pectus Services of Arizona, LLC
• Alexander Pedenko, M.D.
• Alexis Dianne Pedersen, PA C
• Michelle Rose Pedersen, ACNP
• Ali Pederson, PHARM.D.
• Mackenzie Tailleur Pederson
• Pediatras Arizona
• Pediatria

• Certified Registered Nurse Anesthetist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Certified Registered Nurse Anesthetist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.