Jana Pedersen, DNP, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP60998181 Issued in WA

Practice address

1410 N Mullan Rd Ste 200
Spokane Valley, WA 99206-4046

Phone

(509) 838-1188

NPI assigned

Nov 4, 2019

Last updated

Aug 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jana.pedersen.1@11411.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Spokane, WA
  • NPI 1326005851
  Medicare reassignment NPD
• Grow and Flow Wellness Co.

  • Primary Care Clinic/Center
  • Spokane Valley, WA
  • NPI 1487435541
  NPD Authorized official
• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Spokane, WA
  • NPI 1598976409
  NPD
• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Spokane, WA
  • NPI 1679363592
  NPD
• Bear Creek Pediatrics

  • Pediatric Nurse Practitioner
  • Spokane, WA
  • NPI 1518470137
  NPD (past)
• Own Family Medicine and Wellness LLC Dba Active Family Healthcare

  • Family Medicine Physician
  • Coeur d'Alene, ID
  • NPI 1942116884
  NPD (past)

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1699319483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 N MULLAN RD STE 200",
            "city": "SPOKANE VLY",
            "state": "WA",
            "postal_code": "992064046",
            "telephone_number": "509-251-2087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 N MULLAN RD STE 200",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992064046",
            "telephone_number": "509-838-1188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1410 N Mullan Rd",
            "address_purpose": "LOCATION",
            "city": "Spokane Valley",
            "state": "WA",
            "postal_code": "992064043",
            "country_code": "US",
            "telephone_number": "509-838-1188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "JANA",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-04",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60998181",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "59364",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peak Interventional Radiology, P.L.L.C.
• Peaks and Plains Medical, Inc. (MyMedSupplies)
• Pearson and Weary Pain Relief Clinics P.C.
• Kelli K Pearson, DC
• Maya Mikiko Peck
• Jeffrey R Pedersen, DO
• Madeline Annelise Pedersen, LSWA
• Annette Pederson, RD
• Pediatric Home Care, Inc. (Aveanna Healthcare)
• Haley Pemberton

• Nurse Practitioner in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.