Individual provider Active NPI

Ronnie Elaine Edmundson, NP

  • Family Nurse Practitioner
  • Goldsboro, NC
National Provider Identifier
1053198069
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F09230426 Issued in NC
Practice address
2706 Medical Office PL
Goldsboro, NC 27534-9460
Phone
(919) 734-4736
Fax
(919) 580-1017
NPI assigned
Sep 12, 2023
Last updated
Sep 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F09230426 NC Primary

Addresses

Primary practice location

2706 Medical Office PL
Goldsboro, NC 27534-9460

Mailing address

405 Quail Dr
Goldsboro, NC 27534-1846
Phone (919) 920-8954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F09230426NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Goldsboro Pediatrics PA PastSince Sep 1, 2023 Accepting new patients
Goldsboro Pediatrics PA PastSince Sep 1, 2023 Accepting new patients
Goldsboro Pediatrics PA PastSince Dec 24, 2023 Accepting new patients
Goldsboro Pediatrics PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: redmundson@goldsboropeds.medentdirect.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1053198069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 QUAIL DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275341846",
            "telephone_number": "919-920-8954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2706 MEDICAL OFFICE PL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349460",
            "telephone_number": "919-734-4736",
            "fax_number": "919-580-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMUNDSON",
        "first_name": "RONNIE",
        "middle_name": "ELAINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-12",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F09230426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.