JACOB EDMONDSON MA
NPI 1477374379
Counselor - Mental Health in Montpelier, VT
About Jacob Edmondson Ma NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACOB EDMONDSON MA (NPI 1477374379) is an individual mental health provider in Montpelier, Vermont and active in the NPI registry since October 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jacob Edmondson Ma is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Jacob Edmondson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Gibsonia, PA 15044
- Reassigned Medicare billing, Pennsylvania and Vermont enrollments
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MONTPELIER, VT 05602
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jacob Edmondson's NPI number?
The NPI number for Jacob Edmondson is 1477374379. It was assigned to this individual provider in the NPPES registry on October 23, 2024.
Where is Jacob Edmondson located?
Jacob Edmondson practices at 149 State St Unit 6, Montpelier, VT 05602. The listed phone number is (802) 522-8298.
What is Jacob Edmondson's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Jacob Edmondson enrolled in Medicare?
Yes. Jacob Edmondson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Jacob Edmondson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Edmondson reassigns Medicare benefits to Wildwood Therapy Collective LLC (Gibsonia, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacob Edmondson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jacob Edmondson was last updated on October 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Jacob Edmondson, MA · NPI 1477374379
Mental Health provider in Montpelier, Vermont. Individual provider, active in the CMS NPPES registry since October 23, 2024.
## Identity
- **NPI:** 1477374379 (Entity type: Individual)
- **Enumerated:** October 23, 2024
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 149 STATE ST UNIT 6, Montpelier, VT 05602-2965
- **Phone:** (802) 522-8298
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Wildwood Therapy Collective LLC (NPI 1831989482, Gibsonia, PA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** October 23, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1477374379) · Data from the CMS NPPES public registry.