Kellie Edwardsen, AGACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

AP143845 Issued in TX

Practice address

221 W Colorado Blvd
Dallas, TX 75208-2363

Phone

(214) 934-8424

NPI assigned

Nov 6, 2019

Sex

Female

Sole proprietor

No

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 TX

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dallas Pulmonary and Critical Care PAGroup PAC ID 2163679200, 186 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical City Dallas Hospital Hospital, Dallas, TX, CCN 450647

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dallas Pulmonary & Critical Care PA

  • Critical Care Medicine (Internal Medicine) Physician
  • Dallas, TX
  • NPI 1235402728

  Acute Care

  Medicare reassignment Care Compare group NPD

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

• Columbia Hospital at Medical City Dallas Subsidiary LP

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1023180502
  Care Compare affiliation
• Columbia Hospital at Medical City Dallas Subsidiary LP

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1689628984
  Care Compare affiliation

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1982248548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6808 SOUTHPOINT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752482226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W COLORADO BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752082363",
            "telephone_number": "214-934-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDSEN",
        "first_name": "KELLIE",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-06",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP143845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Michael Edwards Jr.
• Toxi Edwards, NP
• Trinket Labridget Edwards, NP-C
• William Leslie Edwards, PHD
• Yolunda Edwards
• Jonathan E Efron, M.D.
• Guy Etan Efune, MD
• Proshad Nemati Efune, M.D.
• Efw Primary Care Services
• Donald Egan, MD, MPH

• Acute Care Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Acute Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.