Jill Elizabeth Edison, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

G81587 Issued in CA

Practice address

435 Doyle Park Dr
Santa Rosa, CA 95405-4515

Phone

(707) 527-9510

Fax

(707) 527-1306

NPI assigned

Aug 9, 2005

Last updated

Dec 6, 2010By 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291593600000",
    "number": "1225039514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 DOYLE PARK DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054515",
            "telephone_number": "707-527-9510",
            "fax_number": "707-527-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 DOYLE PARK DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054515",
            "telephone_number": "707-527-9510",
            "fax_number": "707-527-1306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDISON",
        "first_name": "JILL",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2010-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G81587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G815870",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Steven Eccles, PT
• Lorigail Trinidad Echipare, D.O
• Kirsten Eckert, CNM
• Harvey Eckhart, D.C.
• Caroline Elayda Edillor
• Paul Anthony Ednilao, RN
• Edward L Feldman MD
• Roxanne Edwards-Georges
• Kea Edwards, MD
• Phillip Archie Edwards

• Nephrology Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; 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.