Kimberly Edgmon, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

24371 Issued in OK

Practice address

2820 N Kelly Ave
Suite 200
Edmond, OK 73003-3007

Phone

(405) 726-8000

Fax

(405) 726-8101

NPI assigned

Mar 27, 2006

Last updated

May 27, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• Kimberly Edgmon MD, PLLC

  • Pediatrics Physician
  • Edmond, OK
  • NPI 1831556612
  Authorized official Same address or phone
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464307200000",
    "number": "1164482501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 N KELLY AVE",
            "address_2": "SUITE 200",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730033007",
            "telephone_number": "405-726-8000",
            "fax_number": "405-726-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 N KELLY AVE",
            "address_2": "SUITE 200",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730033007",
            "telephone_number": "405-726-8000",
            "fax_number": "405-726-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGMON",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2016-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "24371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "24371",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OBNDD",
            "identifier": "33536",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200057440A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Edmond, OK
• Providers in Edmond, OK by specialty
• Pediatrics Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; 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.