Active NPI
Emily Pederson
- Physical Therapy Assistant
- Wilmington, NC
National Provider Identifier
1760149330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A7067
- Practice address
- 1134 Harbour Dr Apt 104
Wilmington, NC 28401-7708 - Phone
- (218) 261-1587
- NPI assigned
- Nov 18, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A7067 | NC | Primary |
Addresses
Primary practice location
1134 Harbour Dr Apt 104
Wilmington, NC 28401-7708
Mailing address
1134 Harbour Dr Apt 104
Wilmington, NC 28401-7708
Phone (218) 261-1587
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A7067 | NC | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637193600000",
"number": "1760149330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1134 HARBOUR DR APT 104",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284017708",
"telephone_number": "218-261-1587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1134 HARBOUR DR APT 104",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284017708",
"telephone_number": "218-261-1587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDERSON",
"first_name": "EMILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-18",
"last_updated": "2021-11-18",
"certification_date": "2021-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NC",
"license": "A7067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.