Jerome Edge, CPC

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

CG61267837 Issued in WA

Practice address

4120 Meridian St Ste 220
Bellingham, WA 98226-5575

Phone

(360) 922-3030

NPI assigned

Oct 4, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1093430902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HULBUSH LN APT 14",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982331036",
            "telephone_number": "360-949-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 MERIDIAN ST STE 220",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982265575",
            "telephone_number": "360-922-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGE",
        "first_name": "JEROME",
        "credential": "CPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": "CG61267837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Peer Specialist in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Peer Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.