LARS PEDERSON


Address: 7308 Nw 114th St, Oklahoma City, OK 73162
Phone: 4054735817

LARS PEDERSON (NPI# 1760973705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1760973705
Entity Type Individual
Full Name LARS PEDERSON
Practice Address 7308 Nw 114th St
Oklahoma City
OK 73162
Mailing Address 7308 Nw 114th St
Oklahoma City
OK 73162-2703
Practice Telephone 4054735817
Enumeration Date 2018-05-25
Last Update Date 2018-12-13
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 175T00000X Peer Specialist Other Service Providers

Office Location

Street Address 7308 NW 114TH ST
City OKLAHOMA CITY
State OK
Zip Code 73162

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1114493319 Anthony Haislip Peer Specialist 6904 Briar Creek Dr., Oklahoma City, OK 73162 2018-10-16
1770026841 Cory Chambers Dentist 12321 N. Council Rd, Oklahoma City, OK 73162 2016-11-22
1487109062 K. Williams Case Manager/Care Coordinator 10400 North Council Road, Oklahoma City, OK 73162 2016-08-24
1932537669 Al Dowell Case Manager/Care Coordinator 8849 Nw 121st St., Oklahoma City, OK 73162 2013-10-15
1508106378 Wilvia Wong-plum Counselor 7309 N.w. 107th St., Oklahoma City, OK 73162 2013-02-15
1386912301 Delores Parker Counselor 11916 Silvermoon Drive, Oklahoma City, OK 73162 2011-12-05
1518241744 Victor Njoh Pharmacist 7101 West Hefner Rd, Oklahoma City, OK 73162 2011-10-06
1841500113 Kimmi Jo Stanley Speech-Language Pathologist 9400 St. Ann's Home, Oklahoma City, OK 73162 2010-10-20
1548493091 Glen Knight Wallace Counselor 7932 Nicholson, Okalhoma City, OK 73162 2009-09-01
1154564409 Catherine E. Porter Psychiatry & Neurology 6701 West Hefner Road, Suite B, Oklahoma City, OK 73162 2009-04-16
Find all providers in zip 73162

Taxonomy Information

Taxonomy Code 175T00000X
Grouping Other Service Providers
Classification Peer Specialist

Taxonomy Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Notes: Source: National Uniform Claim Committee [7/1/2014: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1861002818 Keegan Eisenhardt Peer Specialist 6405 S Villa Ave, Oklahoma City, OK 73159-2741 2020-08-05
1689283780 Gregory Purvis Jr. Peer Specialist 1305 Parkwoods Ct, Oklahoma City, OK 73110-7425 2020-07-24
1609485762 Amanda Elaine Cruz Peer Specialist 1605 Nw 30th St Apt 228, Oklahoma City, OK 73118-3622 2020-07-24
1063021384 Christina Len Petty Peer Specialist 2144 Nw 29th St, Oklahoma City, OK 73107-2526 2020-07-23
1104443977 Jennifer Lynn Cobb Peer Specialist 2400 General Pershing Blvd Apt 308, Oklahoma City, OK 73107-6429 2020-06-28
1801412135 Cleborn Gossett Peer Specialist 721 Waterview Rd, Oklahoma City, OK 73170-1637 2020-06-23
1487270617 Foxy S Starnes Peer Specialist 9008 N Shannon Ave, Oklahoma City, OK 73132-1142 2020-06-23
1154945582 Alexandra Paige Mcgowan-rayburn Peer Specialist 4129 Nw 21st St, Oklahoma City, OK 73107-2607 2020-06-01
1962034504 Crystal Rose Mckee Peer Specialist 3417 S Independence Ave, Oklahoma City, OK 73119-2617 2020-02-11
1508496662 Brie Jordan Florence Peer Specialist 2640 Sw 95th St, Oklahoma City, OK 73159-6720 2020-01-16
Find all providers in OKLAHOMA CITY

Competitor

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City OKLAHOMA CITY
Zip Code 73162

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Dataset Information

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.

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