Edicine Im PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

EDICINE IM PLLC

Practice address

4270 S Decatur Blvd Ste A1
Las Vegas, NV 89103-6801

Phone

(702) 423-9566

NPI assigned

Jun 2, 2023

Organization subpart

No

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

Authorized official

Name

Michael Paul Carson

Title

Billing Manager

Phone

(480) 626-1415

Specialties & licenses 3

Addresses

Tax ID family

Edicine Im PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Edicine Im PLLC

  • Internal Medicine Physician
  • North Las Vegas, NV
  • NPI 1821772724
  NPD tax ID
• Edicine Im PLLC

  • Internal Medicine Physician
  • Henderson, NV
  • NPI 1982388054
  NPD tax ID
• Edicine Im PLLC

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1013313691
  NPD tax ID

Locations

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

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685664000000",
    "number": "1205520376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34597 N 60TH ST STE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852665241",
            "telephone_number": "480-488-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4270 S DECATUR BLVD STE A1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891036801",
            "telephone_number": "702-423-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDICINE IM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "480-626-1415"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy L Edgemon, CCC-SLP
• Indeaya Edgerson
• Edgewood Medical LLC
• Rebecca L Edgeworth, MD
• Shariquitka Edgleston
• Julie Edington Bagley, RN
• Jennifer Edington
• Mark David Edington, D.D.S.
• Harresha Laquisha Edison
• Maurice Edison

• Internal Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; 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.