Individual provider Active NPI

Amanda Joy Edmond, PA-C

  • Physician Assistant
  • Gilbert, AZ
National Provider Identifier
1770767683
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8620 Issued in AZ
Practice address
2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone
(480) 256-6444
Fax
(480) 256-3359
NPI assigned
Dec 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1088 MN
Physician Assistant 363A00000X 8620 AZ Primary

Addresses

Primary practice location

2946 E Banner Gateway Dr
Gilbert, AZ 85234

Mailing address

2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-6444

Other practice location 1

4884 Miller Trunk Hwy
Hermantown, MN 55811-1504
Phone (218) 249-5700

Other identifiers 1

IdentifierTypeStateIssuer
1088OtherMNMN LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address agrace74136@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080327000423 MN Practitioner - Physician Assistant 9133205354 Reassigns benefits to 1 organization
I20220120001811 AZ Practitioner - Physician Assistant 9133205354 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165
Phone (480) 256-6444

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Physician Assistant

State licenses

LicenseStateTypeSpecialty
1088MNMDMidwife
8620AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Urgent Care, LLC CurrentSince Oct 1, 2023 Accepting new patients
Banner Cancer Center Specialists LLC CurrentSince Apr 24, 2023 Accepting new patients
Allina Health System CurrentSince May 1, 2011 Accepting new patients
Allina Health System CurrentSince May 1, 2011 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Dec 19, 2025 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Dec 19, 2025 Accepting new patients
Prescott Healthcare Solutions LLC PastSince Oct 19, 2023 Accepting new patients

Locations

3648 W Anthem Way
Bldg A100C
Anthem, AZ 85086
Phone (623) 434-6444

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

2946 E Banner Gateway Dr
Rm 2008
Gilbert, AZ 85234
Phone (480) 256-4523

2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-5450

835 W University Dr
Mesa, AZ 85201
Phone (480) 664-6007

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

122 E Main St
Payson, AZ 85541
Phone (928) 474-2888

701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

Interoperability endpoints

  • Direct secure messaging: agrace74136@excellian.direct.allina.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1770767683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2946 E BANNER GATEWAY DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85234",
            "telephone_number": "480-256-6444",
            "fax_number": "480-256-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2946 E BANNER GATEWAY DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85234",
            "telephone_number": "480-256-6444",
            "fax_number": "480-256-3359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4884 Miller Trunk Hwy",
            "address_purpose": "LOCATION",
            "city": "Hermantown",
            "state": "MN",
            "postal_code": "558111504",
            "country_code": "US",
            "telephone_number": "218-249-5700",
            "fax_number": "218-249-4666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDMOND",
        "first_name": "AMANDA",
        "middle_name": "JOY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-27",
        "last_updated": "2025-08-06",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "1088",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN LICENSE",
            "identifier": "1088",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agrace74136@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "701 Dellwood St S",
            "city": "Cambridge",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550081920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.