DR. GLENN JAY PEDERSEN D.C.
NPI 1083706162
Chiropractor in Paoli, IN

Q: What is Glenn Pedersen's NPI number?

The NPI number for Glenn Pedersen is 1083706162. It was assigned to this individual provider in the NPPES registry on September 28, 2006.

Q: What is Glenn Pedersen's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Q: When was this NPI record last updated?

The NPPES record for Glenn Pedersen was last updated on May 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 28, 2006

650 N GOSPEL ST STE 4, PAOLI, IN 47454(812) 252-2225(833) 336-4142 Get Directions Write a Review

NPPES record last updated: May 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 21, 2025, Jan 2, 2019, Dec 21, 2018 (3 updates tracked since 2018).

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About Dr. Glenn Jay Pedersen D.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GLENN JAY PEDERSEN D.C. (NPI 1083706162) is an individual chiropractor in Paoli, Indiana, licensed in Indiana (08000852A) and active in the NPI registry since September 2006. He is a graduate of National College Of Chiropractic (1982).

NPPES Registry Identity

NPI1083706162

Entity TypeIndividualMale

Primary Taxonomy111N00000X

Provider Legal NameDR. GLENN JAY PEDERSENCredential: D.C.

Location Address650 N GOSPEL ST STE 4Paoli, IN 47454-1482

Mailing Address650 N Gospel StPaoli, IN 47454-1483 · (812) 252-2225 · Fax (833) 336-4142

Phone(812) 252-2225

Fax(833) 336-4142

Sole ProprietorYes

Medical School CMSNational College Of ChiropracticGraduated 1982

Enumeration DateSeptember 28, 2006

Last NPPES UpdateMay 21, 20253 updates tracked since enumeration

NPPES CertifiedMay 21, 2025

✔ NPI 1083706162 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

License✔ Licensed in IN · 08000852A

Definition

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

650 N GOSPEL ST STE 4, Paoli, IN 47454

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Other Identifiers 1

Other01682626IL · Blue Cross Blue Shield

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Glenn Jay Pedersen D.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8921005513

PECOS Enrollment IDI20061024000269, I20190103001937

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Chiropractic manipulative treatment, 3-4 spinal regions 98941

Chiropractic manipulative treatment for 3-4 spinal regions involves a trained professional applying controlled force to specific areas of your spine. This can help alleviate pain, improve physical function, and support your body's natural healing process.

407 services19 patients

Chiropractic manipulative treatment, 1-2 spinal regions 98940

Chiropractic manipulative treatment focuses on adjusting your spine to improve your body's physical function. In this service, a chiropractor applies controlled force to 1-2 spinal regions. This helps to restore mobility and alleviate discomfort in those areas.

127 services21 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glenn Pedersen's NPI number?

The NPI number for Glenn Pedersen is 1083706162. It was assigned to this individual provider in the NPPES registry on September 28, 2006.

Where is Glenn Pedersen located?

Glenn Pedersen practices at 650 N Gospel St Ste 4, Paoli, IN 47454. The listed phone number is (812) 252-2225.

What is Glenn Pedersen's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Glenn Pedersen enrolled in Medicare?

Yes. Glenn Pedersen is registered in the Medicare PECOS enrollment system.

What insurance does Glenn Pedersen accept?

Health plans from CareSource list Glenn Pedersen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Glenn Pedersen was last updated on May 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.