Individual provider Active NPI

Harvey Lawrence Edmonds, MD

  • Neurology Physician
  • Fresno, CA
National Provider Identifier
1548342157
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G24725 Issued in CA
Practice address
728 E Bullard Avenue
Suite 104
Fresno, CA 93710
Phone
(559) 436-9800
Fax
(559) 436-9804
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X G24725 CA Primary

Addresses

Primary practice location

728 E Bullard Avenue
Suite 104
Fresno, CA 93710

Mailing address

728 E Bullard Avenue
Suite 104
Fresno, CA 93710
Phone (559) 436-9800

Other identifiers 2

IdentifierTypeStateIssuer
00G247250OtherCAMEDICAL PROV NO
4136936OtherCAMEDICAL UPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060308000310 CA Practitioner - Neurology 8820005325 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G24725CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Agnes Medical Center CurrentSince Feb 7, 2018 Accepting new patients
Trinity Home Health Services CurrentSince Feb 7, 2018 Accepting new patients

Locations

15 E Audubon Dr
Fresno, CA 93720
Phone (559) 433-8000

1303 E Herndon Ave
Fresno, CA 93720
Phone (559) 449-3000

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.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548342157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 E BULLARD AVENUE",
            "address_2": "SUITE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93710",
            "telephone_number": "559-436-9800",
            "fax_number": "559-436-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 E BULLARD AVENUE",
            "address_2": "SUITE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93710",
            "telephone_number": "559-436-9800",
            "fax_number": "559-436-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDS",
        "first_name": "HARVEY",
        "middle_name": "LAWRENCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G24725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PROV NO",
            "identifier": "00G247250",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL UPIN",
            "identifier": "4136936",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.