Nathan John Edmundson, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810005996 Issued in VA

Practice address

118 E del Ray Ave
Alexandria, VA 22301

Phone

(703) 348-6427

NPI assigned

Sep 18, 2007

Last updated

Jul 20, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brightside Medical, P.C.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1801355482

  TX

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  TX

  Medicare reassignment NPD
• Counseling to Inspire

  dba Theresa L Cicchetto

  • Marriage & Family Therapist
  • Fairfield, CA
  • NPI 1972969715
  NPD (past)
• Counseling to Inspire, Inc.

  • Marriage & Family Therapist
  • Fairfield, CA
  • NPI 1427599703
  NPD (past)
• Whole Kids Co. PLLC

  • Professional Counselor
  • Colorado Springs, CO
  • NPI 1932617792
  NPD (past)

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1861688384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 1/2 E DEL RAY AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223011234",
            "telephone_number": "626-665-7582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E DEL RAY AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "22301",
            "telephone_number": "703-348-6427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 E Del Ray Ave",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223011324",
            "country_code": "US",
            "telephone_number": "703-348-6427",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 E Saint Vrain St",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809031123",
            "country_code": "US",
            "telephone_number": "719-473-9200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 Oliver Rd Ste 193",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945343431",
            "country_code": "US",
            "telephone_number": "707-514-5812",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "306 1/2 E Del Ray Ave",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223011234",
            "country_code": "US",
            "telephone_number": "202-250-0287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDMUNDSON",
        "first_name": "NATHAN",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-18",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "0004017",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY29380",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810005996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36550264",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Nicole Edge, NP
• Christine Sharkey Edgerton, NP
• Caroline Edgeton-Martin, M.S.ED., LPC, NCC
• Zinat Edjlali
• Shyrie Ara Edmonson, NP
• Edward E Gahres, Ms, LTD
• Chaz Edwards
• Dean Aria Edwards, DDS
• Deshana Edwards
• Tiffiny R Edwards, LCSW

• Clinical Psychologist in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.