Active NPI
Ernest Wayne Edmonds, PA-C
- Physician Assistant
- Wichita Falls, TX
National Provider Identifier
1295744282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA00973
- Practice address
- 1800 7TH St
Wichita Falls, TX 76301-4204 - Phone
- (940) 723-2373
- Fax
- (940) 723-1890
- NPI assigned
- Aug 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA00973 | TX | Primary |
Addresses
Primary practice location
1800 7TH St
Wichita Falls, TX 76301-4204
Mailing address
4495 Hwy 79 S.
Wichita Falls, TX 76310-0535
Phone (940) 691-4360
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TX 00973 | Other | TX | TEXAS LICENSE/PERMIT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA00973 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295744282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4495 HWY 79 S.",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763100535",
"telephone_number": "940-691-4360",
"fax_number": "940-723-1890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 7TH ST",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763014204",
"telephone_number": "940-723-2373",
"fax_number": "940-723-1890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDMONDS",
"first_name": "ERNEST",
"middle_name": "WAYNE",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA00973",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS LICENSE/PERMIT",
"identifier": "TX 00973",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wichita Falls, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.