NPIMap

Organization Active NPI

Pederson Krag Center

  • Community/Behavioral Health Agency
  • Smithtown, NY
National Provider Identifier
1952609232
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
072099 Issued in NY
Legal business name
PEDERSON KRAG CENTER
Practice address
11 Route 111
Smithtown, NY 11787-3712
Phone
(631) 920-8300
NPI assigned
Mar 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

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

Authorized official

Name
Lauren Rothman, LMSW
Title
Family Specialist
Phone
(631) 920-8351

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 072099 NY Primary

Addresses

Primary practice location

11 Route 111
Smithtown, NY 11787-3712

Mailing address

11 Route 111
Smithtown, NY 11787-3712

National Provider Directory

National Provider Directory
Tax ID family
Pederson Krag4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1299715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299715200000",
    "number": "1952609232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ROUTE 111",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 ROUTE 111",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873712",
            "telephone_number": "631-920-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDERSON KRAG CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-10",
        "last_updated": "2011-03-10",
        "status": "A",
        "authorized_official_last_name": "ROTHMAN",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "FAMILY SPECIALIST",
        "authorized_official_telephone_number": "631-920-8351",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "072099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; 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.