MR. SCOTT MATTHEW EDMONDSON


Address: 630 Mantua Pike, Woodbury, NJ 08096-3233
Phone: 8568122220

MR. SCOTT MATTHEW EDMONDSON (NPI# 1104007285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104007285
Entity Type Individual
Full Name MR. SCOTT MATTHEW EDMONDSON
Credential PA-C
Practice Address 630 Mantua Pike
Woodbury
NJ 08096-3233
Mailing Address Po Box 758952
Baltimore
MD 21275-8952
Practice Telephone 8568122220
Practice Fax Number 8568122221
Mailing Telephone 8049685700
Enumeration Date 2007-11-17
Last Update Date 2015-03-11
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
25MP00352600 NJ Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 630 MANTUA PIKE
City WOODBURY
State NJ
Zip Code 08096-3233

Providers in the same location

NPI Name Taxonomy Address Enumeration
1083663769 Joseph Louis Granito Emergency Medicine 630 Mantua Pike, Woodbury, NJ 08096-3233 2006-05-09
1932670486 Regina M Costroff Physician Assistant 630 Mantua Pike, Woodbury, NJ 08096 2018-12-10
1689021842 Christen Denise Ground Family Medicine 630 Mantua Pike, Woodbury, NJ 08096-3233 2016-05-18
1336538701 Patient First Maryland Physician Group, P.C. Non-Pharmacy Dispensing Site 630 Mantua Pike, Woodbury, NJ 08096-3233 2015-01-22
1609280999 Patient First Maryland Physicians Group, P.C. Family Medicine 630 Mantua Pike, Woodbury, NJ 08096-3233 2014-06-16
1225373111 Adriana Davis Family Medicine 630 Mantua Pike, Woodbury, NJ 08096-3233 2012-12-03
1548524838 Patrick Antonio Family Medicine 630 Mantua Pike, Woodbury, NJ 08096-3233 2012-07-02
1699077909 Fern Elyse Kopp Mulberg Family Medicine 630 Mantua Pike, Woodbury, NJ 08096-3233 2010-11-19
1689698813 Nancy A. Bierman-dear Family Medicine 630 Mantua Pike, Woodbury, NJ 08096-3233 2006-07-27
1891737722 Dale Norman Goode Emergency Medicine 630 Mantua Pike, Woodbury, NJ 08096-3233 2006-06-12
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1780226043 Assoc. for Retarded Citizens, Inc. Gloucester County Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1460 Cooper Street, Deptford, NJ 08096 2019-10-08
1730652058 Robert Crawford Counseling & Consultation, LLC Counselor Robert Crawford Counseling & Consultation, LLC, 44 Cooper Street, Suite 208, Woodbury, NJ 08096 2019-01-09
1902381171 Services To Overcome Drug Abuse Among Teenagers, Inc. Clinic/Center 124 N Broad Street, Woodbury, NJ 08096 2018-10-03
1225518715 Michael West Pharmacist 631 West Mantua Ave, Woodbury, NJ 08096 2018-08-15
1053807891 Standing Ground Counseling, LLC Clinic/Center 44 Cooper Street, Suite 104, Woodbury, NJ 08096 2018-07-05
1376054536 Assoc. for Retarded Citizens, Inc. Gloucester County Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 40 Hessian Avenue, Woodbury, NJ 08096 2017-10-16
1881105021 Assoc. for Retarded Citizens, Inc. Gloucester County Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1154 Bennett Drive, Deptford, NJ 08096 2017-10-16
1215448469 Assoc. for Retarded Citizens, Inc. Gloucester County Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 7 North Evergreen Avenue, Woodbury, NJ 08096 2017-10-16
1801307137 Assoc. for Retarded Citizens, Inc. Gloucester County Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 6 North Drexel Street, Woodbury, NJ 08096 2017-10-13
1295253847 Sara Alven Social Worker 1 Lupton Avenue, Woodbury, NJ 08096 2017-09-05
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1013496892 Daniel Louis Fazzino Physician Assistant 76 Barnhill Rd, Woodbury, CT 06798-2219 2018-08-12
1871789123 Alissa Paul Physician Assistant 449 Commerce Dr, Woodbury, MN 55125-4872 2007-09-20
1457460743 Anthony F Orlando Physician Assistant 608 N Broad St, Suite 100, Woodbury, NJ 08096-1794 2006-08-30
1992746242 Susan Tamagni Physician Assistant 159 S Broad St, Woodbury, NJ 08096-2410 2006-06-09
1437523248 Abigail House Tierney Physician Assistant 1875 Woodwinds Dr, Woodbury, MN 55125-2298 2015-11-17
1396149910 Matthew Voit Physician Assistant 509 N Broad St, Woodbury, NJ 08096-1617 2014-10-09
1588086821 Krystina Zeliff Physician Assistant 875 Mantua Pike, Woodbury, NJ 08096 2014-01-06
1326312430 Brian W. Boockoff Physician Assistant 414 Tatum St, Woodbury, NJ 08096-3499 2012-03-07
1790068989 Leslie Ann Davis Physician Assistant 45 Crossways Park Dr W, Woodbury, NY 11797-2037 2011-09-23
1467733816 Andrea M Bolesta Physician Assistant 509 N Broad St, Woodbury, NJ 08096-1617 2011-08-30
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Competitor

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City WOODBURY
Zip Code 08096

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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