Individual provider Active NPI

M Bruce Edmonson, MD

  • Pediatrics Physician
  • Madison, WI
National Provider Identifier
1598731689
Registry record updated Feb 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20388 Issued in WI
Practice address
2880 University Ave
Madison, WI 53705
Phone
(608) 263-6421
Fax
(608) 265-7958
NPI assigned
Feb 27, 2006
Last updated
Feb 2, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 20388 WI Primary

Addresses

Primary practice location

2880 University Ave
Madison, WI 53705

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531
Phone (608) 829-5485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233532800000",
    "number": "1598731689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531",
            "telephone_number": "608-829-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 UNIVERSITY AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53705",
            "telephone_number": "608-263-6421",
            "fax_number": "608-265-7958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONSON",
        "first_name": "M",
        "middle_name": "BRUCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2009-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "20388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.