NPIMap

Individual provider Active NPI

Brianna Edson, PA-C

  • Physician Assistant
  • Grayling, MI
National Provider Identifier
1003448846
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010255 Issued in MI
Practice address
1200 W North Down River Rd Ste C
Grayling, MI 49738-8024
Phone
(989) 344-5910
Fax
(231) 935-3463
NPI assigned
Feb 10, 2020
Last updated
Dec 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601010255 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1200 W North Down River Rd Ste C
Grayling, MI 49738-8024

Mailing address

1200 W North Down River Rd Ste C
Grayling, MI 49738-8024
Phone (989) 344-5910

Other practice location 1

1280 E Campus Dr
Mount Pleasant, MI 48859-2033
Phone (989) 774-2478

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201214001204 MI Practitioner - Physician Assistant 7315359460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Healthcare GraylingGroup PAC ID 2062736655, 64 clinicians

Practice addresses (Care Compare)

1250 E Michigan Ave
Grayling Community Health Center
Grayling, MI 49738-7074
Phone (989) 348-0550

1250 E Michigan Ave C
Munson Audiology Grayling
Grayling, MI 49738-7074
Phone (231) 935-6455

2585 W Houghton Lake Dr
Prudenville Community Health Center
Prudenville, MI 48651-9624
Phone (989) 366-2900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Grayling CurrentSince Dec 21, 2020 Accepting new patients
Munson Healthcare Grayling CurrentSince Dec 21, 2020 Accepting new patients
Munson Healthcare Grayling Current Accepting new patients

Locations

3781 Momentum Pl
Chicago, IL 60689

1200 W North Down River Rd
Ste C
Grayling, MI 49738
Phone (231) 935-6455

1250 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0550

2585 W Houghton Lake Dr
Prudenville, MI 48651
Phone (989) 348-0055

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

Interoperability endpoints

  • Direct secure messaging: bedson@direct.mhc.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1003448846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W NORTH DOWN RIVER RD STE C",
            "city": "GRAYLING",
            "state": "MI",
            "postal_code": "497388024",
            "telephone_number": "989-344-5910",
            "fax_number": "231-935-3463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W NORTH DOWN RIVER RD STE C",
            "city": "GRAYLING",
            "state": "MI",
            "postal_code": "497388024",
            "telephone_number": "989-344-5910",
            "fax_number": "231-935-3463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1280 E Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "MI",
            "postal_code": "488592033",
            "country_code": "US",
            "telephone_number": "989-774-2478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDSON",
        "first_name": "BRIANNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-12-11",
        "certification_date": "2020-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010255",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayling, MI

Sources for this page

Verify at the official NPI Registry.