Active NPI
Kadence Edelblut
- Medical Physician Assistant
- Norton Shores, MI
National Provider Identifier
1306486881
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 5601009749
- Practice address
- 131 W Seaway Dr
Norton Shores, MI 49444-3759 - Phone
- (231) 375-8065
- NPI assigned
- Jan 13, 2020
- Last updated
- Jan 13, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 5601009749 | MI | Primary |
Addresses
Primary practice location
131 W Seaway Dr
Norton Shores, MI 49444-3759
Mailing address
950 Franklin Ave
Grand Haven, MI 49417-1614
Phone (616) 502-5940
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578873600000",
"number": "1306486881",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 FRANKLIN AVE",
"city": "GRAND HAVEN",
"state": "MI",
"postal_code": "494171614",
"telephone_number": "616-502-5940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 W SEAWAY DR",
"city": "NORTON SHORES",
"state": "MI",
"postal_code": "494443759",
"telephone_number": "231-375-8065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDELBLUT",
"first_name": "KADENCE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-13",
"last_updated": "2020-01-13",
"certification_date": "2020-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MI",
"license": "5601009749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norton Shores, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.