Kathleen Shannon Edmunds, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD2005-0177 Issued in NM

Practice address

111 N Sepulveda Blvd
Ste. 210
Manhattan Beach, CA 90266-6861

Phone

(310) 379-2134

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, OR2 enrollments

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 2

Specialty

Emergency Medicine

Education

University of New Mexico School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Coos Health DistrictGroup PAC ID 1951219310, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairchild Medical Center Hospital, Yreka, CA, CCN 051316
• Southern Coos Hospital & Health Center Hospital, Bandon, OR, CCN 381304

Merit-based Incentive Payment System (MIPS)

Final score

93.78 of 100Reported as apm

Quality

80.38

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Southern Coos Health District

  • Critical Access Hospital
  • Bandon, OR
  • NPI 1588684484
  Medicare reassignment Care Compare group NPD
• Pinnacle Emergency Physicians of Bakersfield, a Professional Corp

  • Emergency Medicine Physician
  • Bakersfield, CA
  • NPI 1619153251
  Medicare reassignment NPD
• San Francisco Emergency Medical Associates

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1134110661
  Medicare reassignment NPD
• Siskiyou Hospital, Inc.

  • Critical Access Hospital
  • Yreka, CA
  • NPI 1093892275
  Medicare reassignment NPD
• American Specialty Physicians Group Inc

  • Emergency Medicine Physician
  • Modesto, CA
  • NPI 1568992923
  Medicare reassignment
• Pinnacle Emergency Physicians of Bakersfield, a Professional Corp

  • Emergency Medicine Physician
  • Bakersfield, CA
  • NPI 1639415862
  NPD
• Southern Coos Health District

  • Critical Access Hospital
  • Bandon, OR
  • NPI 1417094145
  NPD
• Sherman Oaks Emergency Medical Associates

  • Emergency Medicine Physician
  • Sherman Oaks, CA
  • NPI 1518904150
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Siskiyou Hospital, Inc.

  • Critical Access Hospital
  • Yreka, CA
  • NPI 1093892275
  Care Compare affiliation
• Siskiyou Hospital, Inc.

  • Critical Access Hospital
  • Yreka, CA
  • NPI 1952701369
  Care Compare affiliation
• Southern Coos Health District

  • Critical Access Hospital
  • Bandon, OR
  • NPI 1588684484
  Care Compare affiliation

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1619055696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2138 MALCOLM AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256306",
            "telephone_number": "310-597-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N SEPULVEDA BLVD",
            "address_2": "STE. 210",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902666861",
            "telephone_number": "310-379-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMUNDS",
        "first_name": "KATHLEEN",
        "middle_name": "SHANNON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "MD2005-0177",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A101151",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jake Walsh Dupree, MD
• Jaclyn Michelle Duree, M.A. BCBA
• Phyllis Elliott Dworsky, PH.D.
• Rose J Eapen, M.D.
• Laurie Eddleston, LCSW
• Kristin Egan, M.D.
• Michelle Ehrlich, MD
• Steve Elder, D.D.S.
• Electric Edge Physical Therapy P.C.
• Elevate Psychology and Wellness

• Emergency Medicine Physician in Manhattan Beach, CA
• Providers in Manhattan Beach, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.