Nicole Maria Pedersen

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

2001 S Summit Ave
Sioux Falls, SD 57197-0001

Phone

(712) 269-2344

NPI assigned

Feb 2, 2023

Sex

Female

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

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1831895671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 S MARION RD APT 205",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571062807",
            "telephone_number": "615-804-4086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S SUMMIT AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571970001",
            "telephone_number": "712-269-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "NICOLE",
        "middle_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rylan John Dale Pearson, DC
• Anna Peasley
• Jesse Robert Pechous, CRNA
• Angela T. Peck, LAC
• Shannon R Peck, M.D.
• Cole Jason Pederson, COTA
• Jeanette Zespy Pederson, OTR/L
• Kalli Pederson, RDN, LN, CDE
• Kim Pederson, M.D.
• Pediatric Dentistry, Inc.

• Student in an Organized Health Care Education/Training Program in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Student in an Organized Health Care Education/Training Program in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.