DONALD M PEDERSEN PA
NPI 1962592584
Physician Assistant in Salt Lake City, UT

Q: What is Donald Pedersen's NPI number?

The NPI number for Donald Pedersen is 1962592584. It was assigned to this individual provider in the NPPES registry on October 13, 2006.

Q: What is Donald Pedersen's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Donald Pedersen was last updated on July 8, 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.

Active since October 13, 2006

1138 WILMINGTON AVE, SALT LAKE CITY, UT 84106(801) 581-2000 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Donald M Pedersen Pa NPPES

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

DONALD M PEDERSEN PA (NPI 1962592584) is an individual physician assistant in Salt Lake City, Utah, licensed in Utah (104325-1206) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1962592584

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameDONALD M PEDERSENCredential: PA

Location Address1138 WILMINGTON AVESalt Lake City, UT 84106-2819

Mailing AddressPo Box 510004Salt Lake City, UT 84151-0004 · (801) 587-6600

Phone(801) 581-2000

Sole ProprietorNo

Enumeration DateOctober 13, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1962592584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in UT · 104325-1206

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1138 WILMINGTON AVE, Salt Lake City, UT 84106

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

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