Edmund Siebel

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

0102203967 Issued in VA

Practice address

100 Brewster Blvd
Naval Hospital
Camp Lejeune, NC 28547-2538

Phone

(910) 450-3079

NPI assigned

Mar 18, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1962744946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "address_2": "NAVAL HOSPITAL",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472538",
            "telephone_number": "910-450-3079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "address_2": "NAVAL HOSPITAL",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472538",
            "telephone_number": "910-450-3079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Naval Medical Center Portsmouth",
            "address_2": "620 John Paul Jones Circle",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "23708",
            "country_code": "US",
            "telephone_number": "757-953-1813",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 Helicopter Rd",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234598913",
            "country_code": "US",
            "telephone_number": "757-763-3907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIEBEL",
        "first_name": "EDMUND",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-18",
        "last_updated": "2024-11-04",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "VA",
            "license": "0102203967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Sinnett Shepherd, LCSW
• Spencer Shirk, D.O.
• Michael Shoener, IDC
• Shram Dinesh Shukla, B.A., M.D.
• John Michael Siak III
• Brian S Siegel, O.D.
• Brandon Simmons, DDS
• Tiffany Simnick, LPN
• Jeremy Lee Simon, I.D.C.
• Joshua David Simons, MD

• Sports Medicine (Family Medicine) Physician in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• Sports Medicine (Family Medicine) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.