JENNIFER R. PEDERSEN (NPI# 1073606661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073606661 |
| Entity Type | Individual |
| Full Name | JENNIFER R. PEDERSEN |
| Credential | DO |
| Practice Address |
4321 University Pkwy Ste 101 Evans GA 30809 |
| Mailing Address |
Po Box 1705 Augusta GA 30903-1705 |
| Practice Telephone | 7067745995 |
| Practice Fax Number | 7067745996 |
| Mailing Telephone | 7067747760 |
| Mailing Fax Number | 7067747766 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2018-10-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
052616 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000957932B | 05 | |
| SC | G52616 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1303 Dantignac St, Ste 1200, Augusta, GA 309012775 | 7067747760 | 7067747766 |
| 4321 University Pkwy Ste 101, Evans, GA 308093093 | 7067745995 | 7067745996 |
| 820 Saint Sebastian Way Ste 4a, Augusta, GA 309012643 | 7067745995 | 7067745996 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548732027 | Jennifer Pedersen | Physician Assistant | 14314 Canter Trl, Greenville, SC 29609-0964 | 2018-12-21 |
| 1689759383 | Jennifer Elyse Pedersen | Chiropractor | 516 Main Street East, Detroit Lakes, MN 56501 | 2006-10-25 |
| 1831550235 | Jennifer Pedersen | Counselor | 770 Woodlane Road, Mount Holly, NJ 08060 | 2016-03-11 |
| 1720472913 | Jennifer Pedersen | Occupational Therapist | 407 S Main St, Suite 302, Viroqua, WI 54665-2100 | 2015-03-25 |
| 1497086912 | Jennifer Pedersen | Registered Nurse | 1850 N Central Ave Ste 1600, Phoenix, AZ 85004-4633 | 2010-01-22 |
| 1457467904 | Jennifer Ann Pedersen | Family Medicine | 730 E 34th St, Hibbing, MN 55746-5109 | 2006-08-21 |
| Street Address |
4321 UNIVERSITY PKWY STE 101 |
| City | EVANS |
| State | GA |
| Zip Code | 30809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467423608 | John David Blevins | Psychiatry & Neurology | 4321 University Pkwy Ste 101, Evans, GA 30809-3093 | 2006-01-27 |
| 1093868762 | Robert E. Rychly | Internal Medicine | 4321 University Pkwy Ste 101, Evans, GA 30809-3093 | 2007-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326674060 | Dominion Behavioral Health Services LLC | Psychiatric Unit | 817 Prairie Lane, Evans, GEORGIA 30809 | 2020-03-13 |
| 1710478102 | Georgia Dental Professionals, PC | Dentist | 5131 Washington Rd, Evans, GA 30809 | 2018-05-22 |
| 1649770678 | Angel Legare | Physician Assistant | 404 Town Park Blvd Ste 101, Evans, GA 30809 | 2018-02-16 |
| 1952829541 | Felicia Evette Rhodes | Home Health Aide | 715 Jones Creek, Evans, GA 30809 | 2017-09-02 |
| 1659733582 | Patricia J. Stewart Lpc, LLC | Counselor | 465 N. Belair Rd. Ste 2d, Evans, GA 30809 | 2016-03-21 |
| 1114306727 | John Mccaskey | Family Medicine | 465 N Belair Rd Ste 1b, Evans, GA 30809 | 2015-05-28 |
| 1053702878 | Jennifer Wahl | Assistant Behavior Analyst | 1135 Waltons Pass, Evans, GA 30809 | 2015-02-16 |
| 1609298777 | Custom Pharmacy, Inc | Pharmacy | 1202 Town Park Lane, Suite 200, Evans, GA 30809 | 2014-01-09 |
| 1457797938 | Perfect Health Always On Call, LLC | Non-Pharmacy Dispensing Site | 4244 Washington Rd, Evans, GA 30809 | 2013-05-11 |
| 1417207119 | Tommy Battle | Respiratory Therapist, Registered | 101 Pond View, Evans, GA 30809 | 2012-09-11 |
| Find all providers in zip 30809 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427606847 | Ann W Edmundson | Internal Medicine | 15685 Rowe Rd, Milton, GA 30004-2628 | 2019-08-28 |
| 1831758846 | Diabetes and Endocrinology Associates East | Internal Medicine | 1380 Milstead Ave Ne Ste H, Conyers, GA 30012-3864 | 2019-06-12 |
| 1629453428 | Ghada Mohamed Sami Ahmed K Elshimy | Internal Medicine | 1120 15th St # Hb-5025, Augusta, GA 30912-0004 | 2015-07-22 |
| 1639552920 | Shahzeena Hafeez | Internal Medicine | 550 W Peachtree St Nw, Atlanta, GA 30308 | 2015-07-03 |
| 1295122745 | Thaer Idrees | Internal Medicine | 69 Jesse Hill Jr Dr Se Ste 200, Atlanta, GA 30303-3033 | 2015-04-22 |
| 1386056372 | Camille Frances Stanback | Internal Medicine | 550 Peachtree St Ne Ste 1950, Atlanta, GA 30308-2247 | 2014-05-23 |
| 1518377654 | John Gregory Zora | Internal Medicine | 975 Johnson Ferry Rd Ste 400, Atlanta, GA 30342-4736 | 2014-04-29 |
| 1538588249 | Wedad Rahman | Internal Medicine | 1301 Sigman Rd Ne Ste 280, Conyers, GA 30012-3947 | 2014-04-09 |
| 1427493709 | Senior Medical Systems, LLC | Internal Medicine | 220 Hills Creek Rd, Taylorsville, GA 30178-2068 | 2013-05-01 |
| 1437411592 | David Antonio Reyes Umpierrez | Internal Medicine | 550 Peachtree St Ne Fl Mot19, Atlanta, GA 30308-2247 | 2012-06-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.