Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Glenn A Pederson

Individual provider Nurse Practitioner · NPI 1811171408

Glenn A Pederson is a Nurse Practitioner in Jackson, Mississippi. Qualified in 1994, 32 years ago. Practices with Paragon Emergency Services LLC, a 406-clinician group and accepts Medicare assignment. Licensed in Florida and Mississippi.

Years since qualifying
32
Licensed in
FL, MS
In the registry since
2007
Specialties on file
2
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Practice location Address checks out

1850 Chadwick Dr
Jackson, MS 39204-3404
Phone: (601) 376-2944
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence R878258 (MS)
Emergency Medicine Physician Taxonomy 207P00000X · Licence ARNP1604312 (FL)

Record details

NPI number1811171408
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 19, 2007
Last updated in NPPESJuly 9, 2010

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 1994 (32 years in practice)
Group practice Paragon Emergency Services Llc — 406 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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