DR. JERRY RAY PEDERSON (NPI# 1346236999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346236999 |
| Entity Type | Individual |
| Full Name | DR. JERRY RAY PEDERSON |
| Credential | OD |
| Practice Address |
6650 S Vine St Suite 160 Centennial CO 80121-2769 |
| Practice Telephone | 3037985533 |
| Practice Fax Number | 3037982800 |
| Mailing Telephone | 3037985533 |
| Mailing Fax Number | 3037982800 |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2009-06-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
724 | CO | Eye and Vision Services Providers |
| Street Address |
6650 S VINE ST SUITE 160 |
| City | CENTENNIAL |
| State | CO |
| Zip Code | 80121-2769 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952387359 | Joy L Barney | Audiologist | 6650 S Vine St, L-10, Centennial, CO 80121 | 2005-12-16 |
| 1417499138 | Sarah Jane Meyer Dds PC | Dentist | 6650 S Vine St, Suite 240, Centennial, CO 80121-2735 | 2016-11-11 |
| 1962861104 | Grin & Barrett Orthodontics | Dentist | 6650 S Vine St, L-80, Centennial, CO 80121-2735 | 2016-02-16 |
| 1073902441 | Michael J. Franquemont, Dds,plc | Dentist | 6650 S Vine St, Suite 260, Centennial, CO 80121-2735 | 2015-01-22 |
| 1013245422 | Southglenn Endodontics | Dentist | 6650 S Vine St, Ste 200, Centennial, CO 80121-2735 | 2009-11-23 |
| 1073742938 | Jerry R. Pederson, O.d., P.C. | Optometrist | 6650 S Vine St, Suite 160, Centennial, CO 80121-2769 | 2009-07-13 |
| 1114167947 | Southglenn Eyecare, PC | Optometrist | 6650 S Vine St, 160, Centennial, CO 80121-2735 | 2009-03-06 |
| 1679796049 | Michael James Franquemont | Dentist | 6650 S Vine St, Suite 260, Centennial, CO 80121-2769 | 2007-04-11 |
| 1811031859 | Jerry R. Pederson, O.d. | Optometrist | 6650 S Vine St, Suite 160, Centennial, CO 80121-2735 | 2007-02-15 |
| 1427024876 | Luis J Bravo | Dentist | 6650 S Vine St, Suite 120, Centennial, CO 80121-2770 | 2006-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457810889 | Pushpa Sunder Mehta | Obstetrics & Gynecology | 5555 E. Pine Court., Greenwood Village, CO 80121 | 2019-03-15 |
| 1346722378 | Michael Bernard Young | Respiratory Therapist, Registered | 2204 E Panama Drive, Centennial, CO 80121 | 2018-09-06 |
| 1235592676 | Stephen Cheung | Student in an Organized Health Care Education/Training Program | 191 E Orchard Rd Ste 200, Littleton, CO 80121 | 2016-04-02 |
| 1962722629 | James Paul Bieneman | Dentist | 6650 S. Vine Street, Suite 220, Centennial, CO 80121 | 2010-06-04 |
| 1033349774 | Matthew Renner Wimmer | Dentist | 6690 S. Broadway, Centennial, CO 80121 | 2009-07-15 |
| 1134385131 | Paul Adams Hood | Counselor | 6949 South Highway 73, Suite 211, Evergreen, CO 80121 | 2008-07-30 |
| 1063545044 | Marcia J Murphy | Psychologist | 681 E Orchard Road, Centennial, CO 80121 | 2007-03-13 |
| 1417032111 | Edward J. Barrett | Dentist | 6650 S. Vine St, L-80, Centennial, CO 80121 | 2006-10-25 |
| 1255412334 | Donald A Metzger | Optometrist | 6610 S Broadway, Centennial, CO 80121 | 2006-10-17 |
| 1609893171 | Michele Marie Friedl | Dentist | 5959 S University, Greenwood Village, CO 80121 | 2006-07-17 |
| Find all providers in zip 80121 | ||||
| Taxonomy Code | 152WC0802X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Corneal and Contact Management |
| The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407842628 | Jon F Pederson | Optometrist | 2275 E Arapahoe Rd, Suite 105, Centennial, CO 80122-1500 | 2005-09-22 |
| 1245497452 | John L Schachet Od PC | Optometrist | 8586 E Arapahoe Rd, Ste 100, Centennial, CO 80112-1433 | 2008-05-16 |
| 1811031859 | Jerry R. Pederson, O.d. | Optometrist | 6650 S Vine St, Suite 160, Centennial, CO 80121-2735 | 2007-02-15 |
| 1699850412 | John L Schachet | Optometrist | 8586 E Arapahoe Rd, Ste 100, Centennial, CO 80112-1433 | 2006-10-27 |
| 1548376965 | Paul S Conkling | Optometrist | 6881 S Yosemite St, Centennial, CO 80112-1406 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033637046 | Alpenglow Eye Care, Pllc | Optometrist | 611 24 Rd, Grand Junction, CO 81505-1240 | 2017-08-30 |
| 1386014397 | Jeffrey B Holland Od PC | Optometrist | 1350 College Ave Unit 100, Boulder, CO 80302-7389 | 2015-10-02 |
| 1629353172 | Liz Erley | Optometrist | 3301 30th St, Boulder, CO 80301-1401 | 2011-10-17 |
| 1588860571 | Timothy L. Osius Jr. O.d. Inc. | Optometrist | 2980 Ginnala Dr., Suite A, Loveland, CO 80537-2701 | 2007-06-26 |
| 1194936401 | Ryan Thomas Smedley | Optometrist | 8405 Park Meadows Center Dr Ste 1000, Lone Tree, CO 80124-5025 | 2007-05-25 |
| 1891818316 | Superior Eye Care PC | Optometrist | 9948 W 99th Ave, Westminster, CO 80021-4298 | 2007-04-09 |
| 1639291107 | Johnna C Bontadelli | Optometrist | 917 Clydesdale Ln, Windsor, CO 80550-3135 | 2007-04-04 |
| 1164578373 | Nancy Barnard Smith | Optometrist | 1940 Greeley Mall # 27, Greeley, CO 80631-8520 | 2007-01-28 |
| 1154474187 | Kevin C. Pollard | Optometrist | 1516 Xavier St, Suite 101, Denver, CO 80204-1024 | 2007-01-21 |
| 1184794745 | Marc A Provencher | Optometrist | 4050 Timberline Rd, Suite 120, Fort Collins, CO 80525-6032 | 2006-11-09 |
| Find all providers with the same taxonomy | ||||
| City | CENTENNIAL |
| Zip Code | 80121 |
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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.