Jessica Lee Gillilan Edmondson, CRNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1-105098 Issued in AL

Practice address

1600 7TH Ave S BLDG Suite516
Birmingham, AL 35233

Phone

(205) 638-9781

Fax

(205) 975-7051

NPI assigned

Apr 5, 2011

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

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

Medicare enrollment (NPD)

Enrolled

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.

• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment NPD
• University of Alabama Health Services Foundation, PC

  dba UAHSF Department of Pediatrics

  • Pediatrics Physician
  • Birmingham, AL
  • NPI 1356377576
  NPD

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1578852133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 AL HIGHWAY 205",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359565413",
            "telephone_number": "256-572-2791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE S BLDG SUITE516",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35233",
            "telephone_number": "205-638-9781",
            "fax_number": "205-975-7051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "JESSICA",
        "middle_name": "LEE GILLILAN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-105098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faith Breann Edgell, RN
• Amy Dean Edgerton, OTR
• Trevor Edgington
• Henry Graves Edmondson III, CRNA
• Holli Rhea Edmondson, CRNP
• Maycie Edmondson
• Carter Emmett Edmunds
• Hayward Savage Edmunds Jr., M.D.
• Laura Edmundson, MSPT
• Brandon Scott Edney, MD

• Pediatric Nurse Practitioner in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Pediatric Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; 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.