Individual provider Active NPI

Roger Dean Edwards

  • Pharmacist
  • Washington, DC
National Provider Identifier
1043736937
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00010428 Issued in WA
Practice address
4061 Minnesota Ave NE
Washington, DC 20019-3541
Phone
(202) 388-3100
Fax
(202) 388-3102
NPI assigned
Aug 22, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Intermediate Emergency Medical Technician 146M00000X
Licensed Practical Nurse 164W00000X LP00016283 WA
Critical Care Pharmacist 1835C0205X PH00010428 WA
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PH00010428 WA
Ambulatory Care Pharmacist 1835P2201X PH00010428 WA
Pharmacist 183500000X PH00010428 WA Primary

Addresses

Primary practice location

4061 Minnesota Ave NE
Washington, DC 20019-3541

Mailing address

4061 Minnesota Ave NE
Washington, DC 20019-3541
Phone (202) 388-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LP00016283WAMDLicensed Practical Nurse
PH00010428WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
We the People Community Health Worker Coalition PastSince Jul 24, 2022 Accepting new patients
Platinumcare , LLC PastSince Jul 24, 2022 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/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, 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": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1043736937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4061 MINNESOTA AVE NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200193541",
            "telephone_number": "202-388-3100",
            "fax_number": "202-388-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4061 MINNESOTA AVE NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200193541",
            "telephone_number": "202-388-3100",
            "fax_number": "202-388-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ROGER",
        "middle_name": "DEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146M00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Intermediate",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP00016283",
            "primary": false
        },
        {
            "code": "1835C0205X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Critical Care",
            "state": "WA",
            "license": "PH00010428",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WA",
            "license": "PH00010428",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "WA",
            "license": "PH00010428",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00010428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.