Individual provider Active NPI

Kaeli Michelle Edmonds, CRNP

  • Family Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1528439668
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-140046 Issued in AL
Practice address
2780 Bob Wallace Ave SW
Huntsville, AL 35805-4104
Phone
(256) 533-4626
NPI assigned
Oct 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-140046 AL Primary

Addresses

Primary practice location

2780 Bob Wallace Ave SW
Huntsville, AL 35805-4104

Mailing address

2780 Bob Wallace Ave SW
Huntsville, AL 35805-4104
Phone (256) 533-4626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20151119001387 AL Practitioner - Nurse Practitioner 6204136401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Consultants LLCGroup PAC ID 5092603472, 17 clinicians

Practice addresses (Care Compare)

2780 Bob Wallace Ave
Hunstville, AL 35805-4104
Phone (256) 533-4626

2780 Bob Wallace Ave SW
Huntsville, AL 35805-4104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-140046ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Consultants LLC CurrentSince Sep 20, 2024 Accepting new patients

Locations

2780 Bob Wallace Ave SW
Huntsville, AL 35805
Phone (256) 533-4626

2325 Pansy St SW
Ste E
Huntsville, AL 35801
Phone (256) 533-4626

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1528439668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 BOB WALLACE AVE SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358054104",
            "telephone_number": "256-533-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 BOB WALLACE AVE SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358054104",
            "telephone_number": "256-533-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDS",
        "first_name": "KAELI",
        "middle_name": "MICHELLE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-15",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-140046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.