Individual provider Active NPI

Edward Caudill, MSN, FNP-C

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1265244115
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
253121 Issued in AZ
Practice address
11022 N 28TH Dr Ste 270
Phoenix, AZ 85029-5639
Phone
(623) 404-8505
Fax
(602) 429-8475
NPI assigned
Jan 27, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 253121 AZ Primary

Addresses

Primary practice location

11022 N 28TH Dr Ste 270
Phoenix, AZ 85029-5639

Mailing address

11022 N 28TH Dr Ste 270
Phoenix, AZ 85029-5639
Phone (623) 404-8505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20250203001162 AZ Practitioner - Nurse Practitioner 3072042241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wings of Hope Medical Services LLCGroup PAC ID 7719277169, 8 clinicians

Practice addresses (Care Compare)

11022 N 28TH Dr
Suite 270
Phoenix, AZ 85029-5639
Phone (602) 971-0304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wings of Hope Medical Services, LLC CurrentSince Jan 27, 2025 Accepting new patients

Locations

11022 N 28th Dr
Ste 270
Phoenix, AZ 85029
Phone (602) 971-0304

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1265244115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11022 N 28TH DR STE 270",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850295639",
            "telephone_number": "623-404-8505",
            "fax_number": "602-429-8475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11022 N 28TH DR STE 270",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850295639",
            "telephone_number": "623-404-8505",
            "fax_number": "602-429-8475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAUDILL",
        "first_name": "EDWARD",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "253121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.