Brant Pedersen, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

DC-29419 Issued in CA

Practice address

15951 Los Gatos Blvd.
Suite 3
Los Gatos, CA 95032-3428

Phone

(408) 358-5086

Fax

(408) 358-5099

NPI assigned

Jun 13, 2007

Last updated

Jul 9, 2015By the provider in NPPES

Sex

Male

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 CA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 2004

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elliot Francis Ali Foad

  • Chiropractor
  • Los Gatos, CA
  • NPI 1922804004
  Medicare reassignment

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.

• Positive Motion Chiropractic

  • Sports Physician Chiropractor
  • Los Gatos, CA
  • NPI 1861907198
  NPD (past) Authorized official

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1902000979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15951 LOS GATOS BLVD.",
            "address_2": "SUITE 3",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950323428",
            "telephone_number": "408-358-5086",
            "fax_number": "408-358-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15951 LOS GATOS BLVD.",
            "address_2": "SUITE 3",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950323428",
            "telephone_number": "408-358-5086",
            "fax_number": "408-358-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "BRANT",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-29419",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC-29419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stuart Pearlman, M.D.
• Alexis Pearson
• Hattie Dean Pearson, D.O.
• Walter Edward Pearson, M.D.
• Heather Lynne Peck, PH.D.
• Pediatric Health Medical Group
• Peers Associates, Inc
• Pellegrin Broad Morse & Moy MDS & DO (Los Gatos Family Physicians Medical Associates)
• James Michael Pellegrin, MD
• Elmma Judith Pena, P.T.

• Sports Physician Chiropractor in Los Gatos, CA
• Providers in Los Gatos, CA by specialty
• Sports Physician Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.