Individual provider Active NPI

Tanya Edmonds, LPN

  • Licensed Practical Nurse
  • Pikeville, KY
National Provider Identifier
1992931208
Registry record updated Jun 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2029684 Issued in KY
Practice address
119 River Dr
Pikeville, KY 41501-1685
Phone
(606) 437-5500
NPI assigned
Jun 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 2029684 KY Primary

Addresses

Primary practice location

119 River Dr
Pikeville, KY 41501-1685

Mailing address

119 River Dr
Pikeville, KY 41501-1685
Phone (606) 437-5500

Other identifiers 1

IdentifierTypeStateIssuer
20098018MedicaidKY

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

State licenses

LicenseStateTypeSpecialty
2029684KYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243900800000",
    "number": "1992931208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 RIVER DR",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011685",
            "telephone_number": "606-437-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 RIVER DR",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011685",
            "telephone_number": "606-437-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDS",
        "first_name": "TANYA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-02",
        "last_updated": "2009-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "KY",
            "license": "2029684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20098018",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikeville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.