Edicine Im PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

EDICINE IM PLLC

Practice address

2828 E Lake Mead Blvd
North Las Vegas, NV 89030-6548

Phone

(480) 488-8020

NPI assigned

Jun 12, 2023

Last updated

Jun 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Paul Carson

Title

Biilling Manager

Phone

(480) 626-1415

Specialties & licenses 3

Addresses

Tax ID family

Edicine Im PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Edicine Im PLLC

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1205520376
  NPD tax ID
• Edicine Im PLLC

  • Internal Medicine Physician
  • Henderson, NV
  • NPI 1982388054
  NPD tax ID
• Edicine Im PLLC

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1013313691
  NPD tax ID

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1821772724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34597 N 60RH STREET",
            "address_2": "SUITE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852665240",
            "telephone_number": "480-488-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 E LAKE MEAD BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890306548",
            "telephone_number": "480-488-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDICINE IM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-02",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "BIILLING MANAGER",
        "authorized_official_telephone_number": "480-626-1415"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Lamont Eckersley, PA-C
• John Eckert, PA-C
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• Leshay L Eddins
• Edge Therapy LLC
• Edico Health Services, Inc. (Caring Hands Hospice)
• Tymahni Edmead
• Tiffany Renee Edmond, RT
• Wynter Edmondson
• Maxine H Edmunds

• Internal Medicine Physician in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.