Edh1 LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

EDH1 LLC

Practice address

9027 Tibble Creek Way
Charlotte, NC 28227-6670

Phone

(980) 297-0703

NPI assigned

Jul 3, 2019

Last updated

Jul 3, 2019By 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

Mr. Elston Derrek Hooper

Title

Owner

Phone

(980) 297-0703

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562112000000",
    "number": "1942862552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9027 TIBBLE CREEK WAY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282276670",
            "telephone_number": "980-297-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9027 TIBBLE CREEK WAY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282276670",
            "telephone_number": "980-297-0703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDH1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-03",
        "last_updated": "2019-07-03",
        "status": "A",
        "authorized_official_last_name": "HOOPER",
        "authorized_official_first_name": "ELSTON",
        "authorized_official_middle_name": "DERREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "980-297-0703",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela K Edgar Wells, OTR
• Christopher Tremone Edge, MD
• Ann Killian Edgerton, PA-C
• Terra Edgerton
• Edgework Body Therapy
• Amy Beth Edinger, NP
• Zachariah St. Louis Edinger, NP
• Holly Jane Edington, MD
• Bryan Scott Edmiston, DC
• Morgan Emiko Edmiston, DPT

• Clinical Psychologist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.