Glendon Arly Pedersen, APRN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

5581789-4405 Issued in UT

Practice address

440 N Paiute Dr
Cedar City, UT 84721-6181

Phone

(435) 867-1520

Fax

(435) 867-2658

NPI assigned

May 2, 2011

Last updated

Jun 8, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paiute Indian Tribe of UtahGroup PAC ID 3072414952, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Cedar City Hospital Hospital, Cedar City, UT, CCN 460007

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: glendon.pedersen.1@14860.direct.athenahealth.com

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.

• Paiute Indian Tribe of Utah

  dba Four Points Health

  • Clinic/Center
  • Cedar City, UT
  • NPI 1700062296

  TX

  Medicare reassignment Care Compare group
• Paiute Indian Tribe of Utah

  • Clinic/Center
  • Richfield, UT
  • NPI 1336316975
  NPD
• Paiute Indian Tribe of Utah

  • Clinic/Center
  • Kanosh, UT
  • NPI 1992972525
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services, Inc.

  dba Intermountain Health Cedar City Hospital

  • General Acute Care Hospital
  • Cedar City, UT
  • NPI 1538178801
  Care Compare affiliation

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

{
    "created_epoch": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1942591441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 N PAIUTE DR",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847216181",
            "telephone_number": "435-867-1520",
            "fax_number": "435-867-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 N PAIUTE DR",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847216181",
            "telephone_number": "435-867-1520",
            "fax_number": "435-867-2658"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "57 N. 200 E.",
            "address_purpose": "LOCATION",
            "city": "Cedar City",
            "state": "UT",
            "postal_code": "84720",
            "country_code": "US",
            "telephone_number": "435-586-5215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "GLENDON",
        "middle_name": "ARLY",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-02",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "UT",
            "license": "5581789-4405",
            "primary": true
        },
        {
            "code": "247000000X",
            "taxonomy_group": "",
            "desc": "Technician, Health Information",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTAH STATE LICENSE",
            "identifier": "5581789-4405",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alan H Pearson, FNP
• Chelsey Leigh Pearson, PA-C
• Kayce Pearson, DEM
• Robert Dean Pearson, M.D.
• Lisa Peay
• Jennifer Suzanne Pelton
• Sean Gregory Penberthy, DO
• Colten Pendleton
• Kayla Pendleton
• Ashley Perez

• Primary Care Nurse Practitioner in Cedar City, UT
• Providers in Cedar City, UT by specialty
• Primary Care Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.