NPIMap

Individual provider Active NPI

Richard Earl Edwards III, M.D.

  • Family Medicine Physician
  • Jennings, LA
National Provider Identifier
1003059403
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.203926 Issued in LA
Practice address
1322 Elton Rd
Suite P
Jennings, LA 70546-4100
Phone
(337) 824-2282
Fax
(337) 824-0058
NPI assigned
Apr 14, 2009
Last updated
Feb 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD.203926 LA Primary

Addresses

Primary practice location

1322 Elton Rd
Suite P
Jennings, LA 70546-4100

Mailing address

1322 Elton Rd
Suite P
Jennings, LA 70546-4100
Phone (337) 824-2282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120926000596 LA Practitioner - Family Practice 0042469520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in Shreveport, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1322 Elton Rd
Suite P
Jennings, LA 70546-4100
Phone (337) 824-2282

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy45
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Edwards Family Medicine a Professional Medical Corporation Family Medicine Current Accepting new patients
Edwards Family Medicine a Professional Medical Corporation Family Medicine CurrentSince Aug 1, 2012 Accepting new patients
Ochsner American Legion Hospital LLC Past Accepting new patients
Jeff Davis Living Center, LLC Past Accepting new patients
Segura Family Medicine Family Medicine PastSince Aug 1, 2010 Accepting new patients
PMG Opco-Jennings LLC Past Accepting new patients

Locations

1322 Elton Rd
Ste P
Jennings, LA 70546
Phone (337) 494-3278

1636 Elton Rd
Ste 204
Jennings, LA 70546
Phone (337) 654-0871

Interoperability endpoints

  • FHIR API: https://fhir.healthtogo.me/fhir/r4/imed.efm

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rehabilitation Hospital of JenningsJennings, LA, CCN 193067 Hospital General Partnership Interest (4.8%) Jan 1, 2015
Edwards Family Medicine a Professional Medical CorporationJennings, LA, CCN 198915 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
W-2 Managing Employee		 Aug 1, 2012
Aug 1, 2012

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1003059403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 ELTON RD",
            "address_2": "SUITE P",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705464100",
            "telephone_number": "337-824-2282",
            "fax_number": "337-824-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 ELTON RD",
            "address_2": "SUITE P",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705464100",
            "telephone_number": "337-824-2282",
            "fax_number": "337-824-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "RICHARD",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-14",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD.203926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jennings, LA

Sources for this page

Verify at the official NPI Registry.