Jay S. Edmonds, Jr., MD Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G55954 Issued in CA

Legal business name

JAY S. EDMONDS, JR., MD INC.

Practice address

5 Harris CT
BLDG T Suite 103
Monterey, CA 93940-5750

Phone

(831) 375-8880

Fax

(831) 375-8804

NPI assigned

Jun 17, 2006

Organization subpart

No

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

Authorized official

Name

Jay S Edmonds Jr., MD

Title

Owner

Phone

(831) 375-8880

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287532800000",
    "number": "1114962016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 WALTER COLTON DR",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939404230",
            "telephone_number": "831-375-8880",
            "fax_number": "831-375-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 HARRIS CT",
            "address_2": "BLDG T SUITE 103",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405750",
            "telephone_number": "831-375-8880",
            "fax_number": "831-375-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY S. EDMONDS, JR., MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2010-10-20",
        "status": "A",
        "authorized_official_last_name": "EDMONDS",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "831-375-8880",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G55954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "G55954",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000G559540",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Monterey, CA
• Providers in Monterey, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; 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.