Mr. Jon D Pedersen Jr.
Specialist/Technologist, Athletic Trainer in Storrs, Connecticut
1568177129- Practice location
- 2098 Hillside Road, Storrs, CT 06286
- Phone
- 203-980-1516
- Fax
- —
- Last updated
- July 17, 2025
Jon David Pedersen is a Specialist/Technologist, Athletic Trainer based in Storrs, CT. Jon David Pedersen practices in Storrs, CT. The NPI Number for Jon David Pedersen is 1568177129 and holds a License No. 001900 (CT). The current practice location address for Jon David Pedersen is 2098 Hillside Road, Storrs, CT 06286 and can be reached out via phone at 203-980-1516.
Provider Profile Details
- NPI Number
- 1568177129
- Provider Name
- Jon David Pedersen
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 2098 Hillside Road, Storrs, CT 06286
- Phone Number
- 203-980-1516
- Primary Taxonomy
- Specialist/Technologist, Athletic Trainer · 2255A2300X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- January 18, 2023
- Last Update Date
- July 17, 2025
- Certification Date
- July 7, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 2098 Hillside Road
Storrs, CT 06286 - City
- Storrs
- State
- Connecticut
- Zip
- 06286
- Phone Number
- 203-980-1516
Provider Business Mailing Address Details
- Address
- 8 Erico Dr
East Haven, CT 06512-1091 - City
- East Haven
- State
- CT
- Zip
- 06512-1091
- Phone Number
- 230-980-1516
License Information
- License Number
- 001900
- License State
- CT
- Taxonomy
- Specialist/Technologist, Athletic Trainer · 2255A2300X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Mr. Jon D Pedersen Jr.?
The NPI number of Mr. Jon D Pedersen Jr. is 1568177129. It was assigned on January 18, 2023 and is currently active in the NPPES registry.
What is the specialty of Mr. Jon D Pedersen Jr.?
Mr. Jon D Pedersen Jr. is registered under the primary taxonomy Specialist/Technologist, Athletic Trainer (code 2255A2300X), licensed in CT under license number 001900.
Where does Mr. Jon D Pedersen Jr. practice?
The practice location is 2098 Hillside Road, Storrs, CT 06286. The office can be reached at 203-980-1516 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1568177129 directly on the NPPES registry website.