Michelle Pedersen, P.T., PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8793 Issued in AZ

Legal business name

MICHELLE PEDERSEN, P.T., PLLC

Practice address

5655 E Grant Rd
Tucson, AZ 85712-2211

Phone

(520) 603-8640

NPI assigned

Feb 19, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Anne Michelle Pedersen, P.T.

Title

Owner/President

Phone

(520) 603-8640

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1329609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329609600000",
    "number": "1629341854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5655 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122211",
            "telephone_number": "520-603-8640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5655 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122211",
            "telephone_number": "520-603-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE PEDERSEN, P.T., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-19",
        "last_updated": "2012-02-19",
        "status": "A",
        "authorized_official_last_name": "PEDERSEN",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "520-603-8640",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "8793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2012; 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.