David J Pedigo OD PS

Primary specialty

OptometristTaxonomy code 152W00000X

License

277 Issued in AK

Legal business name

DAVID J PEDIGO OD PS

Practice address

1515 E Tudor Rd
Ste 5
Anchorage, AK 99507-1035

Phone

(425) 645-1548

Fax

(425) 328-1254

NPI assigned

Jan 17, 2009

Organization subpart

No

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

Authorized official

Name

Dr. David J Pedigo, OD

Title

President

Phone

(425) 645-1548

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1232150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383782400000",
    "number": "1508003252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 SW EVERETT MALL WAY",
            "address_2": "STE 11",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982042780",
            "telephone_number": "425-645-1548",
            "fax_number": "425-328-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E TUDOR RD",
            "address_2": "STE 5",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071035",
            "telephone_number": "425-645-1548",
            "fax_number": "425-328-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID J PEDIGO OD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-17",
        "last_updated": "2013-11-07",
        "status": "A",
        "authorized_official_last_name": "PEDIGO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-645-1548",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AK",
            "license": "277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023246",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Stacey David-Reay, LCSW
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• Claudette Irene David

• All providers in Anchorage, AK
• Optometrist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; 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.