Edge Integrative Wellness LLC

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

Legal business name

EDGE INTEGRATIVE WELLNESS LLC

Practice address

2450 N Willow Ranch Rd
Tucson, AZ 85749-6705

Phone

(520) 730-2534

NPI assigned

Jan 10, 2018

Organization subpart

No

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

Authorized official

Name

Derek Head

Title

Biller

Phone

(520) 730-2534

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maria Crawford, FNP

  • Family Nurse Practitioner
  • Tucson, AZ
  • NPI 1467691287
  Medicare reassignment NPD

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

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515542400000",
    "number": "1215444393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 N WILLOW RANCH RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857496705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 N WILLOW RANCH RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857496705",
            "telephone_number": "520-730-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGE INTEGRATIVE WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-10",
        "last_updated": "2018-01-10",
        "status": "A",
        "authorized_official_last_name": "HEAD",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "520-730-2534"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11937739",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edams LTC Pharmacy LLC (Edams LTC Pharmacy)
• Edith Edde, DO
• Janet M Eddins
• Steven R Edelman, FNP
• Jennifer Marie Edgar
• Angela Edge
• Robin L Edgell, LMSW
• Luz Edie
• Alec Warren Edison
• Carmen T. Edmerson, M.S., CCC-SLP

• Women's Health Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Women's Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.