Mr Jared Daniel Edmonds, PMHNP in Wilmington, NC

Mr Jared Daniel Edmonds, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Wilmington, North Carolina. His current practice location is 3205 Randall Pkwy Ste 105, Wilmington, North Carolina. You can reach out to his office (for appointments etc.) via phone at (910) 742-9243.

Mr Jared Daniel Edmonds is licensed to practice in North Carolina (license number 5021554) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1245040567.

Contact Information

	Mr Jared Daniel Edmonds, PMHNP
	3205 Randall Pkwy Ste 105, Wilmington, NC 28403-2565
	(910) 742-9243
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Jared Daniel Edmonds
Gender	Male
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	3205 Randall Pkwy Ste 105, Wilmington, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1245040567
Provider Enumeration Date: 01/09/2025
Last Update Date: 02/06/2025

Medicare PECOS Information:

PECOS PAC ID: 3375064835
Enrollment ID: I20250313000151

Medical Identifiers

Medical identifiers for Mr Jared Daniel Edmonds such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1245040567	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	5021554 (North Carolina)	Primary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	245445 (North Carolina)	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Jared Daniel Edmonds allows following entities to bill medicare on his behalf.

Entity Name	Lifesource Of North Carolina
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1811286156 PECOS PAC ID: 7416132428 Enrollment ID: O20110505000743

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jared Daniel Edmonds is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Jared Daniel Edmonds, PMHNP 1012 Justus Dr, Johnson City, TN 37604-6300 Ph: () -	Mr Jared Daniel Edmonds, PMHNP 3205 Randall Pkwy Ste 105, Wilmington, NC 28403-2565 Ph: (910) 742-9243

Reviews and Comments

Nurse Practitioner Nurses in Wilmington, NC

Travis Aaron Finkle, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2909 Market St, Wilmington, NC 28403 Phone: 910-687-4888
Carolyn Jones, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2131 S 17th St, Wilmington, NC 28401 Phone: 910-667-2970
Valerie Lynn Wegener, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8108b Market St, Wilmington, NC 28411 Phone: 910-341-3300 Fax: 910-251-2067
Mrs. Shannon Boney Mathis, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1090 Medical Center Dr, Wilmington, NC 28401 Phone: 910-662-8550 Fax: 910-343-1924
Nannette B Martin, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2131 S 17th St, Wilmington, NC 28401 Phone: 910-772-9202 Fax: 910-772-9452
Elizabeth Granger, NNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2131 S 17th St, Wilmington, NC 28401 Phone: 910-667-2970
Kelly B Miller, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2334 41st St, Wilmington, NC 28403 Phone: 910-641-4095

Mr Jared Daniel Edmonds, PMHNP - Medicare Nurse Practitioner in Wilmington, NC