Individual provider Active NPI

Kathleen O'Connor Edmunds, MD

  • Obstetrics & Gynecology Physician
  • Knoxville, TN
National Provider Identifier
1972579662
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
26543 Issued in TN
Practice address
930 E Emerald Ave
Suite 712
Knoxville, TN 37917-4539
Phone
(865) 684-1766
Fax
(865) 684-1767
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 26543 TN Primary

Addresses

Primary practice location

930 E Emerald Ave
Suite 712
Knoxville, TN 37917-4539

Mailing address

1636 Bickerstaff Blvd
Knoxville, TN 37922-8053
Phone (865) 684-1766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20051222000409 TN Practitioner - Obstetrics/Gynecology 1759303407 Practice locations: Knoxville, TN

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26543TNMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972579662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 BICKERSTAFF BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379228053",
            "telephone_number": "865-684-1766",
            "fax_number": "865-684-1767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 E EMERALD AVE",
            "address_2": "SUITE 712",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379174539",
            "telephone_number": "865-684-1766",
            "fax_number": "865-684-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMUNDS",
        "first_name": "KATHLEEN",
        "middle_name": "O'CONNOR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "26543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.