Individual provider Active NPI

Shawnte Edmond, RN, FNP-C

  • Family Nurse Practitioner
  • Goodyear, AZ
National Provider Identifier
1912413618
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP10713 Issued in AZ
Practice address
13471 W Cornerstone Blvd
Goodyear, AZ 85395-2713
Phone
(623) 583-3001
NPI assigned
Dec 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP10713 AZ Primary

Addresses

Primary practice location

13471 W Cornerstone Blvd
Goodyear, AZ 85395-2713

Mailing address

13471 W Cornerstone Blvd
Goodyear, AZ 85395-2713
Phone (602) 583-3001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20180220002709 AZ Practitioner - Nurse Practitioner 6709147416 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adelante Healthcare, IncGroup PAC ID 4688588643, 132 clinicians
Khakwani and Mohammad Medical PCGroup PAC ID 8527412659, 13 clinicians

Practice addresses (Care Compare)

13471 W Cornerstone Blvd
Goodyear, AZ 85395-2713
Phone (877) 809-5092

1500 S Watson Rd
Suite C104
Buckeye, AZ 85326-8689
Phone (623) 251-7559

15317 W Bell Rd
Suite 100
Surprise, AZ 85374-3900
Phone (877) 809-5092

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adelante Healthcare, Inc. Current Accepting new patients
Adelante Healthcare, Inc CurrentSince Sep 24, 2018 Accepting new patients
Adelante Healthcare, Inc CurrentSince Sep 24, 2018 Accepting new patients
Adelante Healthcare, Inc. Past Accepting new patients
Privia Medical Group Arizona, LLC Past Accepting new patients

Locations

306 E Monroe Ave
Buckeye, AZ 85326
Phone (623) 386-4814

13471 W Cornerstone Blvd
Goodyear, AZ 85395

1705 W Main St
Mesa, AZ 85201
Phone (480) 845-6769

15525 N 83rd Ave
Ste 104
Peoria, AZ 85382

9610 N Metro Pkwy W
Phoenix, AZ 85051
Phone (602) 710-7487

500 W Thomas Rd
Ste 870
Phoenix, AZ 85013
Phone (602) 263-0222

9520 W Palm Ln
Ste 200
Phoenix, AZ 85037
Phone (623) 556-8860

7725 N 43rd Ave
Ste 510
Phoenix, AZ 85051
Phone (623) 207-5465

15317 W Bell Rd
Ste 106
Surprise, AZ 85374
Phone (623) 544-5190

15317 W Bell Rd
Ste 100
Surprise, AZ 85374

15351 W Bell Rd
Surprise, AZ 85374

811 N Tegner St
Ste 113
Wickenburg, AZ 85390

Organizations & group practices 6

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": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1912413618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13471 W CORNERSTONE BLVD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952713",
            "telephone_number": "602-583-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13471 W CORNERSTONE BLVD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952713",
            "telephone_number": "623-583-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMOND",
        "first_name": "SHAWNTE",
        "name_prefix": "Ms.",
        "credential": "RN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-18",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP10713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.