Individual provider Active NPI

Colleen McDuffie Edmond

  • Student in an Organized Health Care Education/Training Program
  • Carson, CA
National Provider Identifier
1679944433
Registry record updated Nov 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
649 E Albertoni St
Carson, CA 90746-1538
Phone
(310) 436-9300
Fax
(310) 436-9331
NPI assigned
Oct 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

649 E Albertoni St
Carson, CA 90746-1538

Mailing address

7323 1/2 Richfield St
Paramount, CA 90723-3311
Phone (347) 903-0450

Other names 1

  • Colleen McDuffie Former name

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447027200000",
    "number": "1679944433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7323 1/2 RICHFIELD ST",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907233311",
            "telephone_number": "347-903-0450",
            "fax_number": "310-436-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 E ALBERTONI ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907461538",
            "telephone_number": "310-436-9300",
            "fax_number": "310-436-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDUFFIE EDMOND",
        "first_name": "COLLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "MCDUFFIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; 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.