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MS. KATHY JANE PEDERSEN PA-C, MPAS
NPI 1265419022
Family Medicine in Salt Lake City, UT

Active since December 22, 2005
4745 S 3200 W, SALT LAKE CITY, UT 84118(801) 964-6214 Get Directions Write a Review

NPPES record last updated: July 19, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ms. Kathy Jane Pedersen Pa-c, Mpas NPPES

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

MS. KATHY JANE PEDERSEN PA-C, MPAS (NPI 1265419022) is an individual family medicine provider in Salt Lake City, Utah, licensed in Utah (102701-1206) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1265419022
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameMS. KATHY JANE PEDERSENCredential: PA-C, MPAS
Location Address4745 S 3200 WSalt Lake City, UT 84118-2822
Mailing Address4745 S 3200 WSalt Lake City, UT 84118-2822 · (801) 964-6214 · Fax (801) 412-6950
Phone(801) 964-6214
Sole ProprietorNo
Enumeration DateDecember 22, 2005
Last NPPES UpdateJuly 19, 2007
✔ NPI 1265419022 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in UT · 102701-1206
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4745 S 3200 W, Salt Lake City, UT 84118
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Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUSANNA BENAVIDEZ CHAPMAN PA
Physician Assistant (Medical)
4745 S 3200 W, TAYLORSVILLE
SALT LAKE CITY, UT 84118
Salt Lake County (801) 964-6214
DR. KEITH OWEN HORWOOD M.D.
Family Medicine
4745 S 3200 W
SALT LAKE CITY, UT 84118
Salt Lake County (801) 964-6214
MRS. MARTHA P MANDUJANO PA-C
Physician Assistant
4745 S 3200 W
SALT LAKE CITY, UT 84118
Salt Lake County (801) 964-6214
MS. LINDA STEARNS RN
Registered Nurse
4745 S 3200 W
SALT LAKE CITY, UT 84118
Salt Lake County (801) 964-6214
DR. KATHERINE ANNE SHEN M.D
Family Medicine
4745 S 3200 W
SALT LAKE CITY, UT 84118
Salt Lake County (801) 964-6214
DR. PAULA ANNE GUERRA M.D.
Family Medicine
4745 S 3200 W
SALT LAKE CITY, UT 84118
Salt Lake County (801) 964-6214
MRS. PHUNG KIM DO PA-C
Physician Assistant
4745 S 3200 W
SALT LAKE CITY, UT 84118
Salt Lake County (801) 964-6214
DR. DAVID MORTIN GONTRUM M.D.
Family Medicine
4745 S 3200 W
SALT LAKE CITY, UT 84118
Salt Lake County (801) 964-6214

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 Kathy Pedersen's NPI number?

The NPI number for Kathy Pedersen is 1265419022. It was assigned to this individual provider in the NPPES registry on December 22, 2005.

Where is Kathy Pedersen located?

Kathy Pedersen practices at 4745 S 3200 W, Salt Lake City, UT 84118. The listed phone number is (801) 964-6214.

What is Kathy Pedersen's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Kathy Pedersen was last updated on July 19, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.