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

Johnathon Ivar Pedersen, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1346056348

Johnathon Ivar Pedersen, FNP-BC is a Nurse Practitioner in Bountiful, Utah. Qualified in 2024, 2 years ago. Practices as a sole proprietor. Licensed in Utah.

Years since qualifying
2
Licensed in
UT
In the registry since
2024
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

230 S Main St
Bountiful, UT 84010-6236
Phone: (801) 698-0544
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 10222638-4405 (UT)

Record details

NPI number1346056348
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-BC
Sole proprietorYes
NPI enumeratedDecember 5, 2024
Last updated in NPPESMarch 16, 2025
Certification dateMarch 16, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations4 on file with Medicare

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