MRS. PAMELA MAE PEDERSEN (NPI# 1114007259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114007259 |
| Entity Type | Individual |
| Full Name | MRS. PAMELA MAE PEDERSEN |
| Credential | LADC |
| Practice Address |
722 S Lincoln Ave Suite 1 York NE 68467-4216 |
| Mailing Address |
71 Kuester Lake Grand Island NE 68801 |
| Practice Telephone | 4023626128 |
| Practice Fax Number | 4023627012 |
| Mailing Telephone | 3083825356 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2007-08-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
326 | NE | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 85276 | 01 | |
| NE | 47052851509 | 05 | |
| NE | 47052851517 | 05 | |
| NE | 47052851582 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194908004 | Pamela Carol Pedersen | Internal Medicine | 48 Lower Newton St, Suite 2, Saint Albans, VT 05478-1907 | 2007-12-13 |
| 1215376553 | Pamela Jean Pedersen | Clinical Nurse Specialist | 660 N Westmoreland Rd, Lake Forest, IL 60045-1659 | 2013-06-20 |
| Street Address |
722 S LINCOLN AVE SUITE 1 |
| City | YORK |
| State | NE |
| Zip Code | 68467-4216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972739670 | Rachel Michelle Koepke | Counselor | 722 S Lincoln Ave, Suite 1, York, NE 68467-4242 | 2009-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174174486 | Isolde Olmsted | Technician | 1311 N. Florida Ave., York, NE 68467 | 2019-09-27 |
| 1568937688 | Patricia Rene Vincent | Licensed Practical Nurse | 1715 N Delaware Ave, York, NE 68467 | 2018-10-04 |
| 1760980494 | Avery Michelle Schneider | Physical Medicine & Rehabilitation | 2222 Lincoln Ave., York, NE 68467 | 2018-01-29 |
| 1689932055 | David S. Wieting | Dentist | 122 West 6th Street, York, NE 68467 | 2012-04-24 |
| 1306033626 | Assisted Living Concepts Inc | Assisted Living Facility | 1810 East 12th Street, York, NE 68467 | 2007-10-01 |
| 1235284043 | Harold Eugene Rosenau | Dentist | 408 Platte Ave, Suite B, York, NE 68467 | 2007-01-24 |
| 1912057662 | Renee L Duffek | Counselor | 202 E 5th, York, NE 68467 | 2007-01-12 |
| 1457422123 | Rebecca Rose Green | Counselor | 722 So Lincoln Ave, Suite 1, York, NE 68467 | 2006-11-13 |
| 1639249220 | Laura Ann Cole | Counselor | 1100 Lincoln Av, Suite F, York, NE 68467 | 2006-11-09 |
| 1023194669 | York General Hospital | Skilled Nursing Facility | 2600 N Lincoln Ave, York, NE 68467 | 2006-10-27 |
| Find all providers in zip 68467 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770132987 | Kylie M Bradley-moreschi | Counselor | 924 W Market St, York, PA 17401-3610 | 2019-09-10 |
| 1003334038 | Amanda Bair | Counselor | 18 S George St Ste 400, York, PA 17401-1418 | 2017-08-30 |
| 1144561598 | Ashley Marie Fisher | Counselor | 1600 Mount Zion Rd, York, PA 17406-7068 | 2013-03-11 |
| 1730423773 | Craig M Schneider | Counselor | 45 Wyntre Brooke Dr, Lower Level, York, PA 17403-4536 | 2012-11-15 |
| 1811121239 | Lori S Cooper-ott | Counselor | 1195 Roosevelt Ave, York, PA 17404-2350 | 2009-05-13 |
| 1558514943 | Yorktowne Psychological Services | Counselor | 220 E King Street, York, PA 17403 | 2008-10-29 |
| 1972763969 | Tanya Peters | Counselor | 722 S Lincoln Ave Ste 1, York, NE 68467-4242 | 2008-06-12 |
| 1659570299 | White Deer Run, Inc | Counselor | 106 Davies Dr, York, PA 17402-8605 | 2007-07-13 |
| 1457422123 | Rebecca Rose Green | Counselor | 722 So Lincoln Ave, Suite 1, York, NE 68467 | 2006-11-13 |
| 1558345926 | Kelvin Morris Silver | Counselor | 18 S George St Ste 230, York, PA 17401-1400 | 2005-11-30 |
| Find all providers in YORK | ||||
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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.