Marta J Edmonds, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0423536 Issued in KS

Practice address

1021 Eisenhower Ave
Great Bend Children's Clinic, P.a.
Great Bend, KS 67530-3213

Phone

(620) 792-5437

NPI assigned

Jan 6, 2006

Last updated

May 25, 2021By the provider in NPPES

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

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KS

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marta.edmonds@khindirect.org
• Direct secure messaging: medmonds636960@direct.kuha.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ukhs Great Bend, LLC

  dba Central Kansas Orthopedic Group

  • Multi-Specialty Clinic/Center
  • Great Bend, KS
  • NPI 1962997197
  Medicare reassignment NPD
• Great Bend Childrens Clinic PA

  • Rural Health Clinic/Center
  • Great Bend, KS
  • NPI 1619955853
  NPD
• Ukhs Great Bend, LLC

  • Rural Health Clinic/Center
  • Great Bend, KS
  • NPI 1073003992
  NPD (past)
• Ukhs Great Bend, LLC

  dba The University of Kansas Health System Great Bend Campus

  • General Acute Care Hospital
  • Great Bend, KS
  • NPI 1548750417
  NPD (past)

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1669450847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 NE 10 RD",
            "address_2": "PO BOX 1816",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675308818",
            "telephone_number": "620-792-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 EISENHOWER AVE",
            "address_2": "GREAT BEND CHILDREN'S CLINIC, P.A.",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303213",
            "telephone_number": "620-792-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDS",
        "first_name": "MARTA",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-06",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "0423536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100127410A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD KS",
            "identifier": "045811",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drmedmonds@grbcc.opdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1021 Eisenhower Ave",
            "address_2": "Great Bend Children's Clinic, P.A.",
            "city": "Great Bend",
            "state": "KS",
            "country_code": "US",
            "postal_code": "675303213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tatum Dunekack, D.D.S.
• Joshua Durr
• Eaglemed LLC
• Earcare of Great Bend, Inc.
• Julie Lynn Eastland, DPT
• Allison Edwards, APRN
• Elder Living LLC (Aster Estates)
• Eldercare Inc
• Kelsey Danielle Elliott, OD
• Taylor Ellis

• Pediatrics Physician in Great Bend, KS
• Providers in Great Bend, KS by specialty
• Pediatrics Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.