Individual provider Active NPI

Alesha Michelle Edwards, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Tennille, GA
National Provider Identifier
1023353497
Registry record updated Apr 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD001216 Issued in GA
Practice address
116 Smith St
Tennille, GA 31089-1465
Phone
(478) 864-3448
Fax
(478) 864-1288
NPI assigned
Dec 11, 2012
Last updated
Apr 3, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X POD001216 GA Primary

Addresses

Primary practice location

116 Smith St
Tennille, GA 31089-1465

Mailing address

2251 W Elm St
P O Box 371
Wrightsville, GA 31096-2017
Phone (478) 864-3448

Other identifiers 1

IdentifierTypeStateIssuer
POD001216OtherGALICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150619001990 GA Practitioner - Podiatry 3971814765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2251 W Elm St
Wrightsville, GA 31096-2017
Phone (478) 864-2600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Care Systems, Inc CurrentSince Jan 21, 2015 Accepting new patients
Community Health Care Systems Inc, CurrentSince Jan 21, 2015 Accepting new patients
Community Health Care Systems, Inc. Current Accepting new patients
Community Health Care Systems,Inc. Past Accepting new patients

Locations

116 Smith St
Tennille, GA 31089
Phone (478) 552-1620

2251 W Elm St
Wrightsville, GA 31096
Phone (478) 864-2600

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428019200000",
    "number": "1023353497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2251 W ELM ST",
            "address_2": "P O BOX 371",
            "city": "WRIGHTSVILLE",
            "state": "GA",
            "postal_code": "310962017",
            "telephone_number": "478-864-3448",
            "fax_number": "478-864-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 SMITH ST",
            "city": "TENNILLE",
            "state": "GA",
            "postal_code": "310891465",
            "telephone_number": "478-864-3448",
            "fax_number": "478-864-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ALESHA",
        "middle_name": "MICHELLE",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-11",
        "last_updated": "2015-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD001216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "POD001216",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tennille, GA

Sources for this page

Verify at the official NPI Registry.