Individual provider Active NPI

Morgan Mae Edmondson, PA

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1841001807
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2700 Evening Side CT
Fort Worth, TX 76179-1706
Phone
(214) 449-4645
NPI assigned
Jan 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2700 Evening Side CT
Fort Worth, TX 76179-1706

Mailing address

2700 Evening Side CT
Fort Worth, TX 76179-1706
Phone (214) 449-4645

Other names 1

  • Morgan Mae Hackbarth Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250429001624 TX Practitioner - Physician Assistant 9032635420 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geode Health of Texas, PLLCGroup PAC ID 2062896897, 158 clinicians

Practice addresses (Care Compare)

610 S Watters Rd
Suite 130
Allen, TX 75013-5008
Phone (469) 854-3263

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
BSW Geode Clinicians of Texas PLLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

1211 W 22nd St
Ste 406
Oak Brook, IL 60523

610 S Watters Rd
Ste 130
Allen, TX 75013
Phone (469) 854-3263

777 International Pkwy
Ste 260
Flower Mound, TX 75022
Phone (214) 310-0508

4119 Montrose Blvd
Ste 230
Houston, TX 77006
Phone (281) 990-1506

768 Bandit Trl
Keller, TX 76248
Phone (817) 865-3954

3009 E Renner Rd
Ste 120
Richardson, TX 75082
Phone (469) 808-1690

7000 Bee Caves Rd
Ste 325
West Lake Hills, TX 78746
Phone (512) 200-8334

Interoperability endpoints

  • Direct secure messaging: morgan.edmondson.1@25899.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1737072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1841001807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 EVENING SIDE CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761791706",
            "telephone_number": "214-449-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 EVENING SIDE CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761791706",
            "telephone_number": "214-449-4645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "MORGAN",
        "middle_name": "MAE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-17",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MORGAN",
            "last_name": "HACKBARTH",
            "middle_name": "MAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.