Annette L. Pedersen, RDN, LD, CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD2323 Issued in OH

Practice address

9417 Broadview Rd
Broadview Heights, OH 44147-2307

Phone

(330) 388-7894

NPI assigned

Feb 28, 2008

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1992974422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9417 BROADVIEW RD",
            "city": "BROADVIEW HEIGHTS",
            "state": "OH",
            "postal_code": "441472307",
            "telephone_number": "330-388-7894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9417 BROADVIEW RD",
            "city": "BROADVIEW HEIGHTS",
            "state": "OH",
            "postal_code": "441472307",
            "telephone_number": "330-388-7894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "ANNETTE",
        "middle_name": "L.",
        "credential": "RDN, LD, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-28",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "OH",
            "license": "288780",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "LD2323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Paul Pannette, LISW-S
• Adrianne Marie Parker, PMHNP-BC
• Donald G Patacca, DDS
• John Bruce Pate
• Paul Bures DO
• Sarah Pennington
• Alyssa Perna
• Raelene Persad-Maharaj, M.A. CCC-SLP
• Heather Jean Petroff, D.D.S
• Julie Ann Pinter, MA CCC- SLP

• Registered Dietitian in Broadview Heights, OH
• Providers in Broadview Heights, OH by specialty
• Registered Dietitian in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.