Individual provider Active NPI

Theresa Kay Edwards, APRN-CNP

  • Gerontology Nurse Practitioner
  • Sidney, OH
National Provider Identifier
1013494558
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN.CNP.022941 Issued in OH
Practice address
1205 Fairington Dr
Sidney, OH 45365-8144
Phone
(937) 492-8431
Fax
(937) 498-5126
NPI assigned
Jul 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X RN301671 OH
Gerontology Nurse Practitioner 363LG0600X APRN.CNP.022941 OH Primary

Addresses

Primary practice location

1205 Fairington Dr
Sidney, OH 45365-8144

Mailing address

1205 Fairington Dr
Sidney, OH 45365-8144
Phone (937) 492-8431

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address theresa.edwards@wilsonhospital.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181001003119 OH Practitioner - Nurse Practitioner 1557612504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wilson Care, LLCGroup PAC ID 4385549666, 58 clinicians

Practice addresses (Care Compare)

1205 Fairington Dr
Sidney, OH 45365-8144
Phone 93749284310000

Hospital & facility affiliations

  • Wilson Home Health Care Home health agency, Sidney, OH, CCN 367238
  • Wilson Memorial Hospital Hospital, Sidney, OH, CCN 360013

Merit-based Incentive Payment System (MIPS)

Final score
86.07 of 100Reported as group
Quality
72.51
Promoting interoperability
100
Improvement activities
40
Cost
81.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science

State licenses

LicenseStateTypeSpecialty
RN301671OHMDGeneral Practice Registered Nurse
APRN.CNP.022941OHMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wilson Care, LLC CurrentSince Nov 25, 2019 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

104 Diamond Dr
Anna, OH 45302
Phone (937) 394-2900

111 E Lynn St
Botkins, OH 45306
Phone (937) 693-1541

11531 State Route 66
Minster, OH 45865
Phone (937) 295-2949

915 Michigan St
Ste 100
Sidney, OH 45365
Phone (937) 419-8049

1079 Fairington Dr
Sidney, OH 45365
Phone (937) 419-8015

750 S 4th Ave
Sidney, OH 45365
Phone (937) 419-8020

915 Michigan St
Sidney, OH 45365
Phone (937) 498-2311

1205 Fairington Dr
Sidney, OH 45365
Phone (937) 492-8431

661 N Vandemark Rd
Sidney, OH 45365
Phone (937) 419-5010

915 Michigan St
Ste 204
Sidney, OH 45365
Phone (419) 996-5224

Interoperability endpoints

  • Direct secure messaging: tedwards219444@direct.osumc.edu
  • FHIR API: https://api.platform.athenahealth.com/107/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1013494558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 FAIRINGTON DR",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453658144",
            "telephone_number": "937-492-8431",
            "fax_number": "937-498-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 FAIRINGTON DR",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453658144",
            "telephone_number": "937-492-8431",
            "fax_number": "937-498-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "THERESA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-27",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "OH",
            "license": "RN301671",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "APRN.CNP.022941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "theresa.edwards@wilsonhospital.medicity.net",
            "affiliation": "N",
            "address_1": "1205 Fairington Dr",
            "city": "Sidney",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453658144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sidney, OH

Sources for this page

Verify at the official NPI Registry.