Active NPI
Ann Killian Edgerton, PA-C
- Physician Assistant
- Charlotte, NC
National Provider Identifier
1417133166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 100356
- Practice address
- 423 S Sharon Amity Rd Ste C
Charlotte, NC 28211-2974 - Phone
- (704) 333-4817
- Fax
- (704) 333-4879
- NPI assigned
- Jan 11, 2008
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 100356 | NC | Primary |
Addresses
Primary practice location
423 S Sharon Amity Rd Ste C
Charlotte, NC 28211-2974
Mailing address
423 S Sharon Amity Rd Ste C
Charlotte, NC 28211-2974
Phone (704) 333-4817
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
| License | State | Type | Specialty |
|---|---|---|---|
| 100356 | NC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200009600000",
"number": "1417133166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "423 S SHARON AMITY RD STE C",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282112974",
"telephone_number": "704-333-4817",
"fax_number": "704-333-4879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "423 S SHARON AMITY RD STE C",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282112974",
"telephone_number": "704-333-4817",
"fax_number": "704-333-4879"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDGERTON",
"first_name": "ANN",
"middle_name": "KILLIAN",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-11",
"last_updated": "2008-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "100356",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.