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Contact Information

JERRY R. PEDERSON, O.D.
6650 S VINE ST
SUITE 160
CENTENNIAL, CO80121-2735
 Phone: 303-798-5533
 Fax: 303-798-2800
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Corneal and Contact Management

152WC0802X 41 Optometry
Indicates primary specialty

NPI Profile & details for JERRY R. PEDERSON, O.D.

NPI Number 1811031859
LBN Legal business name JERRY R. PEDERSON, O.D.
Authorized official JERRY PEDERSON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/15/2007
Last updated 04/17/2008 - About 18 years ago
Identifiers
CO License # 724
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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