Tiffany Edmonson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

100 Medical Center Dr
Hazard, KY 41701-9421

Phone

(606) 706-2611

NPI assigned

Jan 29, 2024

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

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tedmonson479310@direct.stlukeshealth.org

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.

• Central Kentucky Radiology PLLC

  • Diagnostic Radiology Physician
  • Lexington, KY
  • NPI 1952350761

  Physician Assistant

  Medicare reassignment NPD

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1205698941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7050 BROOKHOLLOW WEST DR # 406666",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772400895",
            "telephone_number": "606-706-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER DR",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019421",
            "telephone_number": "606-706-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONSON",
        "first_name": "TIFFANY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Main Street Pharmacy
• East Perry Elementary
• Eastern Mountain Family & Support Services Inc.
• Benny Eaterling
• Carolyn M Eddington, APRN
• Ek Wellness Group LLC
• Amanda Eldridge
• Freida Eldridge, LCSW
• Dawn Elkins, LPCC
• Raymond Elsoueidi, M.D.

• Physician Assistant in Hazard, KY
• Providers in Hazard, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.