Individual provider Active NPI

Ashley Edmonds

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1053603134
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7155-C Issued in NV
Practice address
6375 W Charleston Blvd Ste a-100
Las Vegas, NV 89146-1139
Phone
(702) 253-0818
Fax
(702) 253-9625
NPI assigned
May 9, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7155-C NV Primary
Social Worker 104100000X

Addresses

Primary practice location

6375 W Charleston Blvd Ste a-100
Las Vegas, NV 89146-1139

Mailing address

8936 Spanish Ridge Ave
Las Vegas, NV 89148-1354
Phone (702) 498-8292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210802000896 NV Order and Referring Only - Clinical Social Worker 9537563358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7155-CNVMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1053603134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8936 SPANISH RIDGE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481354",
            "telephone_number": "702-498-8292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6375 W CHARLESTON BLVD STE A-100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461139",
            "telephone_number": "702-253-0818",
            "fax_number": "702-253-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDS",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-09",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "7155-C",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.