NPIMap

Organization Active NPI

Edens Place LLC

  • Registered Nurse
  • Birmingham, AL
National Provider Identifier
1679178768
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
Legal business name
EDENS PLACE LLC
Practice address
6107 Broadwing Rd
Birmingham, AL 30324
Phone
(404) 442-5001
NPI assigned
Dec 4, 2020
Last updated
Dec 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Authorized official

Name
Ednecia FitzpatrickNPI 1205439841
Title
Owner
Phone
(803) 849-2925

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X Primary

Addresses

Primary practice location

6107 Broadwing Rd
Birmingham, AL 30324

Mailing address

6107 Broadwing Rd
Birmingham, AL 30324

National Provider Directory

National Provider Directory
Tax ID family
Edens Place LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607040000000",
    "number": "1679178768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6107 BROADWING RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "30324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6107 BROADWING RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "30324",
            "telephone_number": "404-442-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDENS PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-04",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-02",
        "status": "A",
        "authorized_official_last_name": "FITZPATRICK",
        "authorized_official_first_name": "EDNECIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-849-2925"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; 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.