NPIMap

Organization Active NPI

Kenneth Edwards

  • Community/Behavioral Health Agency
  • Chicago, IL
National Provider Identifier
1043764897
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
180010430 Issued in IL
Legal business name
KENNETH EDWARDS
Practice address
2133 W Thomas St
Chicago, IL 60622-3629
Phone
(214) 662-1060
NPI assigned
Aug 10, 2016
Last updated
Aug 10, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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

Authorized official

Name
Kenneth EdwardsNPI 1306383245
Title
Therapist
Phone
(214) 662-1040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 180010430 IL Primary

Addresses

Primary practice location

2133 W Thomas St
Chicago, IL 60622-3629

Mailing address

2133 W Thomas St
Chicago, IL 60622-3629

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470787200000",
    "number": "1043764897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2133 W THOMAS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2133 W THOMAS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223629",
            "telephone_number": "214-662-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH EDWARDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-10",
        "last_updated": "2016-08-10",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "214-662-1040"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "180010430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; 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.