Timothy Edwards, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0466007549 Issued in IL

Practice address

121 N Grand Ave W
Springfield, IL 62702-2562

Phone

(217) 528-3233

Fax

(217) 528-4511

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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.

• Springfield Clinic, LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1780638478
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 16, 2007.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1023036696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 N GRAND AVE W",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627022562",
            "telephone_number": "217-528-3233",
            "fax_number": "217-528-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N GRAND AVE W",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627022562",
            "telephone_number": "217-528-3233",
            "fax_number": "217-528-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "0466007549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desiree Marie Edmondson, MD
• Edward a Trudeau MD SC
• David Joseph Edwards, MA, PROFESSIONAL COU
• Kathleen M Edwards, LMFT
• Robert P Edwards, O.D.
• Reagan Egan
• Sarah Rae Eggleston, PA-C
• Nicole Eghtesadi, MD
• Maureen Egizii
• Ashley Egler, MD

• All providers in Springfield, IL
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.