OrganizationActive
Southglenn Eyecare, PC
NPI 1114167947 · Optometrist · Centennial, CO
Southglenn Eyecare, PC is a Optometrist organization in Centennial, CO (NPI 1114167947).
Provider details
- NPI number
- 1114167947
- Entity type
- Organization
- Primary specialty
- OptometristEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- Jon Pederson, Doctor(303) 798-5533
- License
- 2468 (CO)
Specialties & taxonomies
Eye and Vision Services Providers
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6650 S Vine St
160
Centennial, CO 80121-2735
Phone: (303) 798-5533
Fax: (303) 798-2800
Street-level locationGet directions
Mailing address
6650 S Vine St
Centennial, CO 80121-2735
Other names (DBA / former)
- Other name
- Jerry R Pederson, O.D., P.C.
Registry dates
- Enumerated
- 2009-03-06
- Last updated
- 2009-03-06
Frequently asked questions
- What is Southglenn Eyecare, PC's NPI number?
- Southglenn Eyecare, PC's National Provider Identifier (NPI) is 1114167947, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southglenn Eyecare, PC?
- Southglenn Eyecare, PC is classified in the NPPES registry as Optometrist (Eye and Vision Services Providers).
- Where is Southglenn Eyecare, PC located?
- Southglenn Eyecare, PC's practice location on file with NPPES is 6650 S Vine St, Centennial, CO 80121-2735.
- What is Southglenn Eyecare, PC's phone number?
- The practice phone number listed in the NPPES registry for Southglenn Eyecare, PC is (303) 798-5533.
- Who is the authorized official for Southglenn Eyecare, PC?
- The authorized official listed on Southglenn Eyecare, PC's NPPES record is Jon Pederson, Doctor. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southglenn Eyecare, PC's NPI active?
- Yes — Southglenn Eyecare, PC's NPI (1114167947) is active in the NPPES registry as of the last update on 2009-03-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.