Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jared Daniel Edmonds, PMHNP

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1245040567

Mr. Jared Daniel Edmonds, PMHNP is a Nurse Practitioner in Wilmington, North Carolina. Qualified in 2024, 2 years ago. Practices with Lifesource of North Carolina, a 170-clinician group, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
2
Licensed in
NC
In the registry since
2025
Specialties on file
2
What do these letters mean?
PMHNP — Psychiatric-Mental Health Nurse Practitioner
A nurse practitioner specialising in mental health, able to prescribe psychiatric medication.

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Practice location Address checks out

3205 Randall Pkwy Ste 105
Wilmington, NC 28403-2565
Phone: (910) 742-9243
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 5021554 (NC)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 245445 (NC)

Record details

NPI number1245040567
Entity typeIndividual (Type 1)
GenderMale
Credentials PMHNP
Sole proprietorYes
NPI enumeratedJanuary 9, 2025
Last updated in NPPESFebruary 6, 2025
Certification dateFebruary 6, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Lifesource Of North Carolina — 170 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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