Active NPI
Lacrysha Foreman Edmundson, RN
- Registered Nurse
- Knightdale, NC
National Provider Identifier
1972983658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 221697
- Practice address
- 1016 Tellis Dr
Knightdale, NC 27545-8156 - Phone
- (252) 363-4535
- NPI assigned
- Jun 8, 2015
- Last updated
- May 31, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 221697 | NC | Primary |
Addresses
Primary practice location
1016 Tellis Dr
Knightdale, NC 27545-8156
Mailing address
4801 Glenwood Ave Ste 200
Raleigh, NC 27612-3857
Phone (252) 363-4535
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 221697 | NC | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affirm Care LLC | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Home Health Registered Nurse
- Raleigh, NC
- NPI 1568101772
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653955200000",
"number": "1972983658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4801 GLENWOOD AVE STE 200",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276123857",
"telephone_number": "252-363-4535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1016 TELLIS DR",
"city": "KNIGHTDALE",
"state": "NC",
"postal_code": "275458156",
"telephone_number": "252-363-4535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDMUNDSON",
"first_name": "LACRYSHA",
"middle_name": "FOREMAN",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-08",
"last_updated": "2022-05-31",
"certification_date": "2022-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NC",
"license": "221697",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Knightdale, NC
- East Wake Counseling and Consulting, PLLC
- East Wake Home Care
- Mahtsente Worku Ebron, MSHS OTRL
- Madeline Sarah Eck, BCBA
- Lisa May Edmondson, LCSW
- Emily Edwards, LCSW
- Elevate Medical Supplies LLC
- Elite Therapeutic Services
- Christopher Ellenberger, DPT
- Elmore Center for Physical Therapy and Lymphedema Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.