Individual provider Active NPI

Ronda Terese Edmonds, LCSW

  • Clinical Social Worker
  • Burkeville, VA
National Provider Identifier
1336735976
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904012543 Issued in VA
Practice address
4901 E Patrick Henry Hwy
Burkeville, VA 23922-3454
Phone
(804) 926-9119
NPI assigned
Dec 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904012543 VA Primary

Addresses

Primary practice location

4901 E Patrick Henry Hwy
Burkeville, VA 23922-3454

Mailing address

1619 Rocky Hill Rd
Blackstone, VA 23824-4522
Phone (804) 926-9119

Other names 1

  • Ronda Terese Jenkins Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0904012543VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1336735976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 ROCKY HILL RD",
            "city": "BLACKSTONE",
            "state": "VA",
            "postal_code": "238244522",
            "telephone_number": "804-926-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 E PATRICK HENRY HWY",
            "city": "BURKEVILLE",
            "state": "VA",
            "postal_code": "239223454",
            "telephone_number": "804-926-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDS",
        "first_name": "RONDA",
        "middle_name": "TERESE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904012543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RONDA",
            "last_name": "JENKINS",
            "middle_name": "TERESE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Burkeville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.