NPIMap

Individual provider Active NPI

Katherine D. Pedersen, RDH, PHRDH

  • Dental Hygienist
  • North Platte, NE
National Provider Identifier
1912267618
Registry record updated May 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
2153 Issued in NE
Practice address
111 North Dewey
North Platte, NE 69101-0648
Phone
(308) 696-1201
Fax
(308) 696-1204
NPI assigned
May 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 2153 NE Primary

Addresses

Primary practice location

111 North Dewey
North Platte, NE 69101-0648

Mailing address

P.O. Box 648
111 North Dewey
North Platte, NE 69101-0648
Phone (308) 696-1201

Other names 1

  • Katherine (Katy) Donelle Carr Former name

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

LicenseStateTypeSpecialty
2153NEMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338249600000",
    "number": "1912267618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 648",
            "address_2": "111 NORTH DEWEY",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691010648",
            "telephone_number": "308-696-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 NORTH DEWEY",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691010648",
            "telephone_number": "308-696-1201",
            "fax_number": "308-696-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "KATHERINE",
        "middle_name": "D.",
        "credential": "RDH, PHRDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-29",
        "last_updated": "2012-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NE",
            "license": "2153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE (KATY)",
            "last_name": "CARR",
            "middle_name": "DONELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Platte, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; 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.