Individual provider Active NPI

Yutasha Edinbyrd, REGISTERED NURSE

  • Registered Nurse
  • Arlington, TX
National Provider Identifier
1700237351
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
827023 Issued in TX
Practice address
3815 Wrentham Dr
Arlington, TX 76016-2778
Phone
(817) 455-2757
NPI assigned
Jun 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 827023 TX
Case Management Registered Nurse 163WC0400X 827023 TX
Community Health Registered Nurse 163WC1500X 827023 TX
Home Health Registered Nurse 163WH0200X 827023 TX
Hospice Registered Nurse 163WH1000X 827023 TX
Pediatric Registered Nurse 163WP0200X 827023 TX
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 827023 TX
Psychiatric/Mental Health Registered Nurse 163WP0808X 827023 TX
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 827023 TX
Case Manager/Care Coordinator 171M00000X 827023 TX
Contractor 171W00000X 827023 TX
Community Health Worker 172V00000X
Registered Nurse 163W00000X 827023 TX Primary

Addresses

Primary practice location

3815 Wrentham Dr
Arlington, TX 76016-2778

Mailing address

3815 Wrentham Dr
Arlington, TX 76016-2778
Phone (817) 455-2757

Other names 1

  • Yutasha E Jackson 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

State licenses

LicenseStateTypeSpecialty
827023TXMDAdministrator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1700237351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 WRENTHAM DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760162778",
            "telephone_number": "817-455-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 WRENTHAM DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760162778",
            "telephone_number": "817-455-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDINBYRD",
        "first_name": "YUTASHA",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "TX",
            "license": "827023",
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "TX",
            "license": "827023",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "TX",
            "license": "827023",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "TX",
            "license": "827023",
            "primary": false
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "TX",
            "license": "827023",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "TX",
            "license": "827023",
            "primary": false
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "TX",
            "license": "827023",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TX",
            "license": "827023",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "TX",
            "license": "827023",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "TX",
            "license": "827023",
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "TX",
            "license": "827023",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "827023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YUTASHA",
            "last_name": "JACKSON",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.