Connie Edelen, MD

Primary specialty

Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X

License

ME134775 Issued in FL

Practice address

4266 Sunbeam Rd
Jacksonville, FL 32257-2425

Phone

(904) 407-7700

Fax

(904) 407-6001

NPI assigned

May 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: cedelen413262@direct.shands.ufl.edu

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1063620722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4266 SUNBEAM RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322572425",
            "telephone_number": "904-407-7700",
            "fax_number": "904-407-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4266 SUNBEAM RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322572425",
            "telephone_number": "904-407-7700",
            "fax_number": "904-407-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDELEN",
        "first_name": "CONNIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "NC",
            "license": "2010-00028",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116018187",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "FL",
            "license": "ME134775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ecorah Comfort Homecare Services, LLC
• Ecuadental PLLC
• Ed Waters Transport Inc
• Sumanth Kumar Edara, RPH
• Destiny Rae Eddards
• Hannah Devore Edelstein
• Erica Kendra Eden, DDS
• Adria L Edenfield II, PA
• David Edenfield, D.C.
• Jonathan Edenfield, M.S. OTR/L

• Hospice and Palliative Medicine (Family Medicine) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Hospice and Palliative Medicine (Family Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; 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.