DR. ETHAN ALEXANDER EDMONDSON MD, MPH
NPI 1447719687
Student in an Organized Health Care Education/Training Program in Houston, TX

Q: What is Ethan Edmondson's NPI number?

The NPI number for Ethan Edmondson is 1447719687. It was assigned to this individual provider in the NPPES registry on March 18, 2019.

Q: What is Ethan Edmondson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Edmondson was last updated on March 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 18, 2019PECOS Enrolled

1 BAYLOR PLZ # BCM320, HOUSTON, TX 77030(832) 824-1170(832) 825-9302 Get Directions Write a Review

NPPES record last updated: March 18, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Ethan Alexander Edmondson Md, Mph NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ETHAN ALEXANDER EDMONDSON MD, MPH (NPI 1447719687) is an individual student in an organized health care education/training program in Houston, Texas and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS and is a graduate of Baylor College Of Medicine (2019).

NPPES Registry Identity

NPI1447719687

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. ETHAN ALEXANDER EDMONDSONCredential: MD, MPH

Location Address1 BAYLOR PLZ # BCM320Houston, TX 77030-3411

Mailing Address1 Baylor Plz # Bcm320Houston, TX 77030-3411 · (832) 824-1170 · Fax (832) 825-9302

Phone(832) 824-1170

Fax(832) 825-9302

Sole ProprietorNo

Medical School CMSBaylor College Of MedicineGraduated 2019

Enumeration DateMarch 18, 2019

✔ NPI 1447719687 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1 BAYLOR PLZ # BCM320, Houston, TX 77030

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ethan Alexander Edmondson Md, Mph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7416458195

PECOS Enrollment IDI20250903001488

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KHANH LINH NGUYEN MD

Student in an Organized Health Care Education/Training Program