Individual provider Active NPI

Debra L Andrews-Pederse, RN

  • Registered Nurse
  • Lakewood, CO
National Provider Identifier
1679761878
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
112557 Issued in CO
Practice address
2932 S Deframe Way
Lakewood, CO 80228-4983
Phone
(303) 716-0055
NPI assigned
Oct 12, 2007
Last updated
Oct 12, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 112557 CO Primary

Addresses

Primary practice location

2932 S Deframe Way
Lakewood, CO 80228-4983

Mailing address

2932 S Deframe Way
Lakewood, CO 80228-4983
Phone (303) 716-0055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
112557COMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192147200000",
    "number": "1679761878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2932 S DEFRAME WAY",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802284983",
            "telephone_number": "303-716-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2932 S DEFRAME WAY",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802284983",
            "telephone_number": "303-716-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS-PEDERSE",
        "first_name": "DEBRA",
        "middle_name": "L",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-12",
        "last_updated": "2007-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "112557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; 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.