Individual provider Active NPI

Simon Louis Edwards, PA-C

  • Medical Physician Assistant
  • Wheat Ridge, CO
National Provider Identifier
1013966092
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
914 Issued in CO
Practice address
8300 W 38TH Ave
Wheat Ridge, CO 80033-6005
Phone
(303) 425-2525
NPI assigned
May 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 914 CO Primary

Addresses

Primary practice location

8300 W 38TH Ave
Wheat Ridge, CO 80033-6005

Mailing address

126 N Greeley Ave
Johnstown, CO 80534-8516
Phone (970) 587-8794

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20060228000194 CO Practitioner - Physician Assistant 7810903945 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
914COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Service Physicians, Inc. Emergency Medicine CurrentSince Jul 26, 1996 Accepting new patients
Platte Valley Medical Group, LLC CurrentSince Jan 1, 2020 Accepting new patients
Emergency Service Physicians, Inc. Emergency Medicine CurrentSince Jul 26, 1996 Accepting new patients
Platte Valley Medical Group, LLC CurrentSince Jan 1, 2020 Accepting new patients
Pridemark Paramedic Services, LLC Past Accepting new patients

Locations

4859 Yampa St
Denver, CO 80249
Phone (303) 498-1885

1450 Dexter St
Ste 102
Fort Lupton, CO 80621
Phone (303) 857-7873

1000 Lincoln St
Fort Morgan, CO 80701
Phone (970) 542-3320

8300 W 38th Ave
Wheat Ridge, CO 80033
Phone (303) 425-2015

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1013966092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 N GREELEY AVE",
            "city": "JOHNSTOWN",
            "state": "CO",
            "postal_code": "805348516",
            "telephone_number": "970-587-8794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 W 38TH AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336005",
            "telephone_number": "303-425-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "SIMON",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

Verify at the official NPI Registry.