Individual provider Active NPI

Thomas L Edmondson, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Baltimore, MD
National Provider Identifier
1659340230
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
D0045766 Issued in MD
Practice address
1311 Park Ave
Baltimore, MD 21217-4104
Phone
(410) 961-5500
Fax
(800) 600-4124
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X D0045766 MD Primary

Addresses

Primary practice location

1311 Park Ave
Baltimore, MD 21217-4104

Mailing address

1311 Park Ave
Baltimore, MD 21217-4104
Phone (410) 961-5500

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

State licenses

LicenseStateTypeSpecialty
D0045766MDMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Helixcare Medical Group, LLC Past Accepting new patients
Franklin Square Hospital Center, Inc. Past Accepting new patients

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1659340230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 PARK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212174104",
            "telephone_number": "410-961-5500",
            "fax_number": "800-600-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 PARK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212174104",
            "telephone_number": "410-961-5500",
            "fax_number": "800-600-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "THOMAS",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MD",
            "license": "D0045766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.