ALEXIS DIANNE PEDERSEN PA C NPI 1306425970

NPI Information

NPI: 1306425970
Provider Name: ALEXIS DIANNE PEDERSEN, PA C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
2902 W AGUA FRIA FWY STE 1000
PHOENIX, AZ
ZIP 85027
Phone: (623) 582-6420
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Alexis Dianne Pedersen, PA C is a medical physician assistant in Phoenix, AZ with 3 years of experience. Alexis Dianne Pedersen, PA C NPI is 1306425970. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2902 W AGUA FRIA FWY STE 1000
PHOENIX, AZ
ZIP 85027-969
Phone: (623) 582-6420
Fax: (623) 582-6720

The NPI 1306425970 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/2/2021 and was last updated on 12/5/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				No
2	363AM0700X	Physician Assistant	Medical	8682	ARIZONA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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