Individual provider Active NPI

Jordon Christopher Edlund, PA-C

  • Trauma Surgery Physician
  • Danville, PA
National Provider Identifier
1164047791
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
1161206 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-9800
Phone
(240) 291-4816
NPI assigned
Jun 9, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X 1161206 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-9800

Mailing address

19704 Jeffery Dr
Hagerstown, MD 21742-4200
Phone (240) 291-4816

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200818001992 PA Practitioner - Physician Assistant 4082030218 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lancaster General Hospital 520 clinicians

Practice addresses (Care Compare)

540 N Duke St
Lancaster, PA 17602-2374
Phone (717) 544-4995

555 N Duke St
Lancaster, PA 17602-2250

Hospital & facility affiliations

  • Lancaster General Hospital Hospital, Lancaster, PA, CCN 390100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1161206PAMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Sep 8, 2020 Accepting new patients
Lancaster General Hospital CurrentSince May 6, 2024 Accepting new patients
Lancaster General Hospital Trauma Surgery CurrentSince May 6, 2024 Accepting new patients
Lancaster General Hospital CurrentSince Jul 8, 2024 Accepting new patients
Geisinger Clinic CurrentSince Sep 8, 2020 Accepting new patients
Lancaster General Medical Group Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

540 N Duke St
Ste 110
Lancaster, PA 17602
Phone (717) 290-4995

555 N Duke St
Lancaster, PA 17602
Phone (717) 544-5945

Organizations & group practices 21

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 21

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1164047791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19704 JEFFERY DR",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217424200",
            "telephone_number": "240-291-4816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "240-291-4816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDLUND",
        "first_name": "JORDON",
        "middle_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-09",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "PA",
            "license": "1161206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.