Individual provider Active NPI

Vernon J Edmondson, APRN-CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Austin, TX
National Provider Identifier
1174388409
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1044681 Issued in TX
Practice address
2501 W William Cannon Dr BLDG 4
Austin, TX 78745-5281
Phone
(512) 472-4357
NPI assigned
Feb 15, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1044681 TX Primary

Addresses

Primary practice location

2501 W William Cannon Dr BLDG 4
Austin, TX 78745-5281

Mailing address

501 E Oltorf St Apt 218
Austin, TX 78704-5625
Phone (617) 935-4004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240803000433 TX Practitioner - Nurse Practitioner 6608313945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rock Springs Physician Group LLCGroup PAC ID 2365751468, 16 clinicians

Practice addresses (Care Compare)

700 SE Inner Loop
Georgetown, TX 78626-7700
Phone (512) 819-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1044681TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Springs Physician Group LLC Psychiatric/Mental Health CurrentSince Jul 23, 2024 Accepting new patients

Locations

1335 E Whitestone Blvd
#200
Cedar Park, TX 78613
Phone (512) 819-9400

700 SE Inner Loop
Georgetown, TX 78626
Phone (512) 351-8769

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1174388409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E OLTORF ST APT 218",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787045625",
            "telephone_number": "617-935-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 W WILLIAM CANNON DR BLDG 4",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787455281",
            "telephone_number": "512-472-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "VERNON",
        "middle_name": "J",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1044681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.