Edelita Remegoso Jamis, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

58538 Issued in AZ

Practice address

15331 W Bell Rd Ste 212
Surprise, AZ 85374-4104

Phone

(760) 278-3592

Fax

(480) 566-9632

NPI assigned

Nov 1, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1942500335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15331 W BELL RD STE 212",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744104",
            "telephone_number": "760-278-3592",
            "fax_number": "480-566-9632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15331 W BELL RD STE 212",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744104",
            "telephone_number": "760-278-3592",
            "fax_number": "480-566-9632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2512 Hurst Drive",
            "address_purpose": "LOCATION",
            "city": "Mattoon",
            "state": "IL",
            "postal_code": "619382500",
            "country_code": "US",
            "telephone_number": "217-258-5900",
            "fax_number": "217-258-5904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMIS",
        "first_name": "EDELITA",
        "middle_name": "REMEGOSO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-01",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125058972",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "58538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trace Jahner, M.S., CF-SLP
• James Care Associates LLC
• David F. James, DDS
• Kylie Delen James
• Tracey J James, LPC
• Roel Conrad Jamis
• Janelle Hultman
• Janelle Janssen
• Jocelyn Jasper, OWNER
• Parita Javia

• Internal Medicine Physician in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.