Individual provider Active NPI

Talena Edmonds

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1598549909
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP023190 Issued in PA
Practice address
5675 N Front St
Philadelphia, PA 19120-2719
Phone
(855) 887-9229
NPI assigned
Aug 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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 SP023190 PA Primary

Addresses

Primary practice location

5675 N Front St
Philadelphia, PA 19120-2719

Mailing address

901 Byers Dr # 1068
Glen Mills, PA 19342-3323

Other practice location 1

17981 Sky Park Cir Ste Bc
Irvine, CA 92614-6309
Phone (877) 896-7350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240424001710 PA Practitioner - Nurse Practitioner 5496195497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5675 N Front St
Rising Sun Health Center
Philadelphia, PA 19120-2719
Phone (215) 279-9666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP023190PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Management Corporation Current Accepting new patients
Public Health Management Corporation CurrentSince Apr 22, 2024 Accepting new patients
Public Health Management Corporation CurrentSince Apr 22, 2024 Accepting new patients
Advantmed Provider Network PastSince Sep 1, 2023 Accepting new patients

Locations

1200 Callowhill St
Ste 101
Philadelphia, PA 19123
Phone (215) 825-8212

5675 N Front St
Philadelphia, PA 19120
Phone (215) 224-0440

Organizations & group practices 4

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": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1598549909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 BYERS DR # 1068",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193423323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5675 N FRONT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202719",
            "telephone_number": "855-887-9229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17981 Sky Park Cir Ste Bc",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926146309",
            "country_code": "US",
            "telephone_number": "877-896-7350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDMONDS",
        "first_name": "TALENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-24",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP023190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.