Individual provider Active NPI

Donna Edmond-King, M.D.

  • Pediatrics Physician
  • Albany, GA
National Provider Identifier
1407950876
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
044711 Issued in GA
Practice address
1712-C East Broad Avenue
Albany, GA 31705
Phone
(229) 639-3103
Fax
(229) 888-8935
NPI assigned
Sep 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 044711 GA Primary

Addresses

Primary practice location

1712-C East Broad Avenue
Albany, GA 31705

Mailing address

204 N Westover Blvd
Albany, GA 31707-2983
Phone (229) 888-6559

Other identifiers 4

IdentifierTypeStateIssuer
727446OtherGABCBS
370010386OtherGARR MCARE
000777378AMedicaidGA
4512970OtherGAAETNA

Other names 1

  • Donna Edmond Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100727000513 GA Practitioner - Pediatric Medicine 7214060375 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
044711GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoebe Family Medicine,Coffee County CurrentSince Dec 1, 2019 Accepting new patients
Phoebe Physician Group, Inc CurrentSince Dec 1, 2019 Accepting new patients
South Atlanta Pediatrics Pediatrics Past Accepting new patients

Locations

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407950876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N WESTOVER BLVD",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317072983",
            "telephone_number": "229-888-6559",
            "fax_number": "229-436-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712-C EAST BROAD AVENUE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "31705",
            "telephone_number": "229-639-3103",
            "fax_number": "229-888-8935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMOND-KING",
        "first_name": "DONNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "044711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "727446",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCARE",
            "identifier": "370010386",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000777378A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4512970",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DONNA",
            "last_name": "EDMOND",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albany, GA

Sources for this page

Verify at the official NPI Registry.