Charles Edmondson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT5987 Issued in MS

Practice address

120 District Blvd Ste D102
Jackson, MS 39211-6382

Phone

(769) 204-8222

Fax

(769) 235-2751

NPI assigned

Oct 12, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Drayer Physical Therapy Mississippi LLC

  • Physical Therapist
  • Louisville, MS
  • NPI 1952732448
  NPD
• Agilitas USA Inc

  • Physical Therapy Clinic/Center
  • Hixson, TN
  • NPI 1962417444

  Physical Therapist

  NPD
• Agilitas USA, Inc

  • Physical Therapy Clinic/Center
  • Chattanooga, TN
  • NPI 1518695436

  Physical Therapist

  NPD
• Drayer Physical Therapy Mississippi LLC

  • Physical Therapist
  • Crystal Springs, MS
  • NPI 1801333521
  NPD (past)

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1770033987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CRESCENT CENTRE DR STE 300",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370677285",
            "telephone_number": "615-373-1350",
            "fax_number": "615-221-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 DISTRICT BLVD STE D102",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392116382",
            "telephone_number": "769-204-8222",
            "fax_number": "769-235-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "CHARLES",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-12",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT5987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Paul Ebel, RD
• Thomas L Eby, MD
• Mary Eddington
• Eboni Eddins
• Dallas Ryan Ederer, MD
• Educare Personal Home Health Services
• Srujan Edupuganti, MBBS
• Amelia Barbara Edwards, OTR
• Amy Lynn Edwards, FNP-C
• Ana-Claire Edwards

• Physical Therapist in Jackson, MS
• Providers in Jackson, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; 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.