Kalen Pedersen, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

124594 Issued in AK

Practice address

813 Lower Mill Bay Rd
Kodiak, AK 99615-7314

Phone

(907) 486-4499

Fax

(907) 486-8211

NPI assigned

May 12, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Arctic Physical Therapy Services, Inc.

  • Physical Therapy Clinic/Center
  • Kodiak, AK
  • NPI 1386817732
  NPD

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1538959523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 LOWER MILL BAY RD",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996157314",
            "telephone_number": "907-486-4499",
            "fax_number": "907-486-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 LOWER MILL BAY RD",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996157314",
            "telephone_number": "907-486-4499",
            "fax_number": "907-486-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "KALEN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AK",
            "license": "124594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia M Parent
• Gregory William Parker, CT
• Heather Parker, DO
• Shelley Ford Paulson, RPH
• Crystaleigh Peacor
• Shanna Lee Peguero Garcia
• Rachel Ruth Pence, LCSW
• Alfred Perkins
• Charles W Phillips, DD
• Doreen Kayla Phillips, BSW, BHP

• Physical Therapy Assistant in Kodiak, AK
• Providers in Kodiak, AK by specialty
• Physical Therapy Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; 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.