Active NPI
Anjali M Edson, P.A.
- Physician Assistant
- Bolivar, MO
National Provider Identifier
1417202425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2012028254
- Practice address
- 1501 N Oakland Ave
Bolivar, MO 65613-3020 - Phone
- (417) 326-7200
- Fax
- (417) 326-7201
- NPI assigned
- Jul 16, 2012
- 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 | 2012028254 | MO | Primary |
Addresses
Primary practice location
1501 N Oakland Ave
Bolivar, MO 65613-3020
Mailing address
2121 E Crawford PL
Salina, KS 67401-3719
Phone (785) 823-0633
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)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stuart Byer M.D. PA | Past | Accepting new patients | |
| Citizens Memorial Healthcare | Physician Assistant | Past | Accepting new patients |
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.
-
- Specialist
- Vero Beach, FL
- NPI 1063533016
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349913600000",
"number": "1417202425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2121 E CRAWFORD PL",
"city": "SALINA",
"state": "KS",
"postal_code": "674013719",
"telephone_number": "785-823-0633",
"fax_number": "785-823-0658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 N OAKLAND AVE",
"city": "BOLIVAR",
"state": "MO",
"postal_code": "656133020",
"telephone_number": "417-326-7200",
"fax_number": "417-326-7201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDSON",
"first_name": "ANJALI",
"middle_name": "M",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-16",
"last_updated": "2012-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MO",
"license": "2012028254",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bolivar, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.