Kelly R Edmondson, CNP, R.N.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R210039 Issued in MD

Practice address

5230 Campbell Blvd
Nottingham, MD 21236-4983

Phone

(330) 263-8428

Fax

(330) 263-8190

NPI assigned

Jul 3, 2006

Last updated

Mar 23, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Certified Nurse Practitioner, Nurse Practitioner, Registered Nurse

State licenses

Interoperability endpoints

• Direct secure messaging: kelly.edmondson.1@18021.direct.athenahealth.com

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1417987793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9146 LENNINGS LN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212374307",
            "telephone_number": "330-263-8428",
            "fax_number": "330-263-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 CAMPBELL BLVD",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364983",
            "telephone_number": "330-263-8428",
            "fax_number": "330-263-8190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "KELLY",
        "middle_name": "R",
        "credential": "CNP, R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "NP08869",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R210039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Nottingham, MD
• Providers in Nottingham, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; 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.