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MRS. JENNIFER K PEDERSON RDN, LD, CDCES
NPI 1710929880
Dietitian, Registered in Chaska, MN

Active since June 12, 2006
111 HUNDERTMARK RD STE 115N, CHASKA, MN 55318(952) 361-2450(952) 361-2461 Get Directions Write a Review

NPPES record last updated: October 14, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mrs. Jennifer K Pederson Rdn, Ld, Cdces NPPES

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

MRS. JENNIFER K PEDERSON RDN, LD, CDCES (NPI 1710929880) is an individual dietitian, registered in Chaska, Minnesota, licensed in Minnesota (1269) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1710929880
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameMRS. JENNIFER K PEDERSONCredential: RDN, LD, CDCES
Location Address111 HUNDERTMARK RD STE 115NChaska, MN 55318-1584
Mailing Address111 Hundertmark Rd Ste 115nChaska, MN 55318-1584 · (952) 361-2450 · Fax (952) 361-2461
Phone(952) 361-2450
Fax(952) 361-2461
Sole ProprietorNo
Enumeration DateJune 12, 2006
Last NPPES UpdateOctober 14, 2024
NPPES CertifiedOctober 14, 2024
✔ NPI 1710929880 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in MN · 1269
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
111 HUNDERTMARK RD STE 115N, Chaska, MN 55318
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Jennifer K Pederson Rdn, Ld, Cdces is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignments

2

Medicare enrollment records show Jennifer Pederson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ridgeview Medical Center
Same address
General Acute Care Hospital
111 HUNDERTMARK RD
Chaska, MN 55318
  • Reassigned Medicare billing, Minnesota enrollment
  • 581 clinicians in this Medicare group
NPI 1710748538 (952) 442-2191
Sibley Medical Center
28 mi
Critical Access
601 WEST CHANDLER STREET
Arlington, MN 55307
  • Reassigned Medicare billing, Minnesota enrollment
  • 229 clinicians in this Medicare group
NPI 1740240225 (507) 964-2271

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 9

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

WHITNEY SUE SARNSTROM CNP
Nurse Practitioner (Family)
111 HUNDERTMARK RD STE 115N
CHASKA, MN 55318
Carver County (952) 777-5661
DR. REBECCA ANN ROSDAHL PHARMD
Pharmacist (Ambulatory Care)
111 HUNDERTMARK RD STE 115N
CHASKA, MN 55318
Carver County (962) 361-2450
DENISE LILIENTHAL RDN, LD
Dietitian, Registered
111 HUNDERTMARK RD STE 115N
CHASKA, MN 55318
Carver County (952) 361-2450
DR. JENNIFER ALLIE AU.D
Audiologist
111 HUNDERTMARK RD STE 115N
CHASKA, MN 55318
Carver County (952) 361-2450
SIDNEY AMOS JONES MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
111 HUNDERTMARK RD STE 115N
CHASKA, MN 55318
Carver County (952) 361-2450
MELANIE BIRTELL RD, LD
Dietitian, Registered
111 HUNDERTMARK RD STE 115N
CHASKA, MN 55318
Carver County (402) 730-1103
RITA WOLF MD
Family Medicine
111 HUNDERTMARK RD STE 115N
CHASKA, MN 55318
Carver County (952) 442-2191
DR. STEPHANIE AMBER REDMOND PHARM.D., CDE
Pharmacist
111 HUNDERTMARK RD STE 115N
CHASKA, MN 55318
Carver County (952) 361-2450

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 Jennifer Pederson's NPI number?

The NPI number for Jennifer Pederson is 1710929880. It was assigned to this individual provider in the NPPES registry on June 12, 2006.

Where is Jennifer Pederson located?

Jennifer Pederson practices at 111 Hundertmark Rd Ste 115N, Chaska, MN 55318. The listed phone number is (952) 361-2450.

What is Jennifer Pederson's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Jennifer Pederson enrolled in Medicare?

Yes. Jennifer Pederson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jennifer Pederson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Pederson reassigns Medicare benefits to 2 organizations: Ridgeview Medical Center (Chaska, MN) and Sibley Medical Center (Arlington, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jennifer Pederson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jennifer Pederson was last updated on October 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.