Active NPI
Chandler Olivia Marie Pederson
- Behavior Analyst
- Omaha, NE
National Provider Identifier
1891383451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 0640
- Practice address
- 9012 Q St
Omaha, NE 68127-3549 - Phone
- (402) 552-9556
- Fax
- (402) 559-5737
- NPI assigned
- Jan 8, 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 0640 | NE | Primary |
Addresses
Primary practice location
9012 Q St
Omaha, NE 68127-3549
Mailing address
985450 Nebraska Medical Ctr
Omaha, NE 68198-5450
Phone (402) 552-9556
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 |
|---|---|---|---|
| 0640 | NE | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752451200000",
"number": "1891383451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "985450 NEBRASKA MEDICAL CTR",
"city": "OMAHA",
"state": "NE",
"postal_code": "681985450",
"telephone_number": "402-552-9556",
"fax_number": "402-559-5737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9012 Q ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681273549",
"telephone_number": "402-552-9556",
"fax_number": "402-559-5737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDERSON",
"first_name": "CHANDLER",
"middle_name": "OLIVIA MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-08",
"last_updated": "2025-07-14",
"certification_date": "2025-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NE",
"license": "0640",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.