Individual provider Active NPI

Aura Leaf Kaila Edmondson, ACNP

  • Acute Care Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1972620318
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP2578 Issued in AZ
Practice address
5301 E Grant Rd
Tucson, AZ 85712-2874
Phone
(520) 324-3771
Fax
(520) 324-8091
NPI assigned
Mar 22, 2007
Last updated
Sep 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP2578 AZ Primary

Addresses

Primary practice location

5301 E Grant Rd
Tucson, AZ 85712-2874

Mailing address

PO Box 31235
Tucson, AZ 85751-1235
Phone (520) 324-4100

Other practice location 1

147 N Brent St
Ventura, CA 93003-2809
Phone (805) 652-3053

Other practice location 2

5151 E Broadway Blvd
Tucson, AZ 85711-3705
Phone (520) 314-1545

Other identifiers 1

IdentifierTypeStateIssuer
674899MedicaidAZ

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
I20120320000723 AZ Practitioner - Nurse Practitioner 7517127004 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMC Medical NetworkGroup PAC ID 9638457013, 276 clinicians

Practice addresses (Care Compare)

5301 E Grant Rd
Tucson, AZ 85712-2805
Phone (520) 324-4230

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tucson Medical Center CurrentSince Jan 18, 2021 Accepting new patients
TMC Medical Network CurrentSince Jul 1, 2021 Accepting new patients
Tucson Medical Center CurrentSince Jan 18, 2021 Accepting new patients
Painted Sky Healthcare, Inc. PastSince Nov 1, 2019 Accepting new patients
Flagstaff Medical Center Past Accepting new patients
Tucson Medical Center Past Accepting new patients

Locations

2380 N Ferguson Ave
Ste 104
Tucson, AZ 85712
Phone (520) 324-1010

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1972620318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31235",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857511235",
            "telephone_number": "520-324-4100",
            "fax_number": "520-300-7326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122874",
            "telephone_number": "520-324-3771",
            "fax_number": "520-324-8091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147 N Brent St",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930032809",
            "country_code": "US",
            "telephone_number": "805-652-3053",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5151 E Broadway Blvd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857113705",
            "country_code": "US",
            "telephone_number": "520-314-1545",
            "fax_number": "520-300-7326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "AURA",
        "middle_name": "LEAF KAILA",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "AP2578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "674899",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.