Meredith Leigh Edholm, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

271779 Issued in NY

Practice address

130 Syracuse St
Tonawanda, NY 14150-5430

Phone

(716) 694-6805

NPI assigned

Aug 12, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1225649320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4280 CHESTNUT RIDGE RD APT F3",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142283112",
            "telephone_number": "716-550-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 SYRACUSE ST",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141505430",
            "telephone_number": "716-694-6805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDHOLM",
        "first_name": "MEREDITH",
        "middle_name": "LEIGH",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "271779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Echo Day Community
• Eckerd Corporation (Rite Aid Pharmacy 10821)
• Eckerd Corporation (Rite Aid Pharmacy 10822)
• Breanna Eckrote, MS
• Amy K Edgerton, TVI/COMS
• Ray Edwards Sr., LPN
• Yasmeen Elhalaby, PT, DPT
• Embrace Mental Health Counseling PC
• Empire Ophthalmology Services, P.C.
• Empire Transportation Provider Inc

• Licensed Practical Nurse in Tonawanda, NY
• Providers in Tonawanda, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.