JESSICA M EDMUNDSON
NPI 1689116303
Counselor - Addiction (Substance Use Disorder) in Canton, OH

Active since November 11, 2016PECOS Enrolled
625 CLEVELAND AVE NW, CANTON, OH 44702(330) 453-8252(330) 453-6716 Get Directions Write a Review

NPPES record last updated: November 11, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jessica M Edmundson NPPES

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

JESSICA M EDMUNDSON (NPI 1689116303) is an individual addiction (substance use disorder) provider in Canton, Ohio, licensed in Ohio (CDCA.130591) and active in the NPI registry since November 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1689116303
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameJESSICA M EDMUNDSON
Location Address625 CLEVELAND AVE NWCanton, OH 44702-1805
Mailing Address625 Cleveland Ave NwCanton, OH 44702-1805 · (330) 453-8252 · Fax (330) 453-6716
Fax(330) 453-6716
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateNovember 11, 2016
✔ NPI 1689116303 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in OH · CDCA.130591
625 CLEVELAND AVE NW, Canton, OH 44702

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jessica M Edmundson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID143709212
PECOS Enrollment IDI20260209003348
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.

Medicare Billing Reassignment

Medicare enrollment records show Jessica Edmundson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, Ohio enrollment
  • 725 clinicians in this Medicare group

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 20

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

Nurse Practitioner (Psychiatric/Mental Health)
625 CLEVELAND AVE NW
CANTON, OH 44702
Counselor (Professional)
625 CLEVELAND AVE NW
CANTON, OH 44702
Counselor (Professional)
625 CLEVELAND AVE NW
CANTON, OH 44702
Counselor (Addiction (Substance Use Disorder))
625 CLEVELAND AVE NW
CANTON, OH 44702
Marriage & Family Therapist
625 CLEVELAND AVE NW
CANTON, OH 44702
Social Worker
625 CLEVELAND AVE NW
CANTON, OH 44702
Counselor (Professional)
625 CLEVELAND AVE NW
CANTON, OH 44702
Counselor
625 CLEVELAND AVE NW
CANTON, OH 44702

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 Jessica Edmundson's NPI number?

The NPI number for Jessica Edmundson is 1689116303. It was assigned to this individual provider in the NPPES registry on November 11, 2016.

Where is Jessica Edmundson located?

Jessica Edmundson practices at 625 Cleveland Ave NW, Canton, OH 44702. The listed phone number is (330) 453-8252.

What is Jessica Edmundson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Jessica Edmundson enrolled in Medicare?

Yes. Jessica Edmundson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jessica Edmundson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jessica Edmundson reassigns Medicare benefits to Grow Healthcare Group PA (Miami, FL). 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 Jessica Edmundson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jessica Edmundson accept?

Health plans from Anthem Blue Cross and Blue Shield, MedMutual and UnitedHealthcare list Jessica Edmundson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jessica Edmundson was last updated on November 11, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.