Individual provider Active NPI

Kathryn Violet Edwards, RN, CPNP

  • Pediatric Nurse Practitioner
  • Dansville, NY
National Provider Identifier
1407093529
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
381979 Issued in NY
Practice address
22 Red Jacket St
Dansville, NY 14437-9502
Phone
(585) 335-5200
Fax
(585) 335-5037
NPI assigned
Jan 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 381979 NY Primary

Addresses

Primary practice location

22 Red Jacket St
Dansville, NY 14437-9502

Mailing address

22 Red Jacket St
P.O. Box 499
Dansville, NY 14437-9502
Phone (585) 335-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090520000006 NY Practitioner - Nurse Practitioner 5193874253 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
381979NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Unity Hospital of Rochester Current Accepting new patients
The Unity Hospital of Rochester CurrentSince Oct 2, 2023 Accepting new patients

Locations

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Interoperability endpoints

  • Direct secure messaging: kathryn.edwards@sbpeds.eclinicaldirectplus.com

Organizations & group practices 2

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": "1231718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1407093529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 RED JACKET ST",
            "address_2": "P.O. BOX 499",
            "city": "DANSVILLE",
            "state": "NY",
            "postal_code": "144379502",
            "telephone_number": "585-335-5200",
            "fax_number": "585-335-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 RED JACKET ST",
            "city": "DANSVILLE",
            "state": "NY",
            "postal_code": "144379502",
            "telephone_number": "585-335-5200",
            "fax_number": "585-335-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KATHRYN",
        "middle_name": "VIOLET",
        "name_prefix": "Mrs.",
        "credential": "RN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-12",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "381979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dansville, NY

Sources for this page

Verify at the official NPI Registry.