Jeffery W. Edstrom

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

23492.0828 Issued in WY

Legal business name

JEFFERY W. EDSTROM

Practice address

1524 W 5TH St
Sheridan, WY 82801-2707

Phone

(307) 672-7874

NPI assigned

Jan 30, 2014

Last updated

Jun 3, 2014By 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

Kimberly J Meier, CPC

Title

Billing Manager

Phone

(307) 674-5123

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffery W Edstrom

  • Certified Registered Nurse Anesthetist
  • Buffalo, WY
  • NPI 1164427274

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

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

{
    "created_epoch": "1391040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1871916544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 767",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828010767",
            "telephone_number": "307-674-5123",
            "fax_number": "307-674-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 W 5TH ST",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828012707",
            "telephone_number": "307-672-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERY W. EDSTROM",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-30",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "MEIER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "307-674-5123",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WY",
            "license": "23492.0828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164427274",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Integrative Health, LLC
• Jacqueline D Adler, MD, LLC
• Sacha James, APRN
• Samantha Lynn Jannelli
• Karl Eric Jantz, LCSW
• Charlotte Jenkins
• Jessica Jenkins, LPC,LADC/MH
• Brett A Jenks, PT, DPT, MDT, CFPS
• Ryan Jenks, MA, CCC-SLP
• Jodi's Heart Inc.

• Certified Registered Nurse Anesthetist in Sheridan, WY
• Providers in Sheridan, WY by specialty
• Certified Registered Nurse Anesthetist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.