Jamie F Edens, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2009-0028 Issued in NM

Practice address

610 Broadway Blvd NE
Albuquerque, NM 87102-2372

Phone

(505) 242-3991

Fax

(505) 243-8405

NPI assigned

Feb 13, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jamie I Fanning Former name

Medicare fee-for-service enrollment

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Presbyterian Healthcare Services

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1104802354
  Medicare reassignment NPD
• New Mexico Oncology Hematology Consultants, LTD.

  • Hematology & Oncology Physician
  • Albuquerque, NM
  • NPI 1164475232
  Medicare reassignment
• Presbyterian Healthcare Services

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  NPD

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1508034588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 BROADWAY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022372",
            "telephone_number": "505-242-3991",
            "fax_number": "505-243-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 BROADWAY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022372",
            "telephone_number": "505-242-3991",
            "fax_number": "505-243-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDENS",
        "first_name": "JAMIE",
        "middle_name": "F",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-13",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "PA2009-0028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "96972351",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "FANNING",
            "middle_name": "I",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James K Eddings
• Michelle Eddings
• Cedar Hart Edell, DO
• Lauren Alexis Edelman, M.D.
• Eden Pharmacy, LLC
• Nancy L Edens, PT
• Anna E Eder, LISW
• Ashley Elizabeth Ederle, MD
• Brianna Cheyenne Edey
• Edgar Montes

• Medical Physician Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Medical Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.