EDGE MEDICAL SERVICES — NPI 1356256523 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in JORDAN, MN)

CMS-1500 Box 24J / 33a • NPI

1356256523

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261QB0400X

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

467 SUNSET DR, JORDAN, MN, 55352-1629

✓ 9-Digit EDI 837 ZIP+4 (55352-1629)

Practice Phone & Referral Fax

(210) 464-3611

Fax: (888) 329-2091

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1356256523 (EDGE MEDICAL SERVICES) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1356256523` (NPI-2 Organization / Facility)
Provider / Legal Name	EDGE MEDICAL SERVICES
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QB0400X` (Clinic/Center, Birthing)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	467 SUNSET DR, JORDAN, MN, 55352-1629
Practice Telephone / Fax	Tel: (210) 464-3611 \| Fax: (888) 329-2091
Administrative Mailing Address	1141 N LOOP 1604 E STE 105-187, SAN ANTONIO, TX, 78232-1339
Enumeration & Last Sync	Enumerated: 2026-08-14 \| CMS Record Updated: 2026-08-14
Authorized Official	FAITH BLEVINS (Admin)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

467 SUNSET DR, JORDAN, MN, 55352-1629

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Plain-English Taxonomy & CMS Crosswalk (261QB0400X)

What Does Taxonomy Code 261QB0400X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QB0400X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (EDGE MEDICAL SERVICES)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261QB0400X` — Clinic/Center, Birthing Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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EDGE MEDICAL SERVICES (NPI #1356256523)