Active NPI
William Edelman, PA
- Physician Assistant
- Destin, FL
National Provider Identifier
1063911196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9100677
- Practice address
- 4485 Furling LN
Destin, FL 32541-5331 - Phone
- (850) 654-1194
- NPI assigned
- Feb 5, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9100677 | FL | Primary |
Addresses
Primary practice location
4485 Furling LN
Destin, FL 32541-5331
Mailing address
4485 Furling LN
Destin, FL 32541-5331
Phone (850) 654-1194
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9100677 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517788800000",
"number": "1063911196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4485 FURLING LN",
"city": "DESTIN",
"state": "FL",
"postal_code": "325415331",
"telephone_number": "850-654-1194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4485 FURLING LN",
"city": "DESTIN",
"state": "FL",
"postal_code": "325415331",
"telephone_number": "850-654-1194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDELMAN",
"first_name": "WILLIAM",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-05",
"last_updated": "2018-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "9100677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Destin, FL
- Andre Drevinskas
- Julia Andreyevna Drevinskas, NP
- Sandra A Dulian, CRNA
- Staci Nicole Duncan, APRN
- Dynamic Pain & Wellness PLLC
- Autum Marie Edgerton, SLP
- Elite Vein Center of Destin LLC (The Vein Center of Florida)
- Elizabeth S. Roberson, M.D., P.a.
- Zandalee Elliott, BCABA
- Emerald Coast Adult Day Care Center LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.