Individual provider Active NPI

Daphne C Edwards, RN, CPNP

  • Nurse Practitioner
  • Colonial Heights, VA
National Provider Identifier
1053569376
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024164386 Issued in VA
Practice address
2493 Boulevard
Colonial Heights, VA 23834-2317
Phone
(804) 504-5490
Fax
(833) 989-0990
NPI assigned
Aug 28, 2008
Reactivated
Mar 30, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 001119792 VA
Pediatric Nurse Practitioner 363LP0200X 0024164386 VA
Nurse Practitioner 363L00000X 0024164386 VA Primary

Addresses

Primary practice location

2493 Boulevard
Colonial Heights, VA 23834-2317

Mailing address

10221 Krause Rd Unit 1262
Chesterfield, VA 23832-1250
Phone (804) 803-3334

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
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
001119792VAMDRegistered Nurse
0024164386VAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peds First Healthcare LLC Pediatrics CurrentSince Apr 6, 2023 Accepting new patients
Virginia Pediatrics PC Past Accepting new patients

Locations

11300 Iron Bridge Rd
Ste D
Chester, VA 23831
Phone (215) 218-8900

10221 Krause Rd
Unit 1262
Chesterfield, VA 23832

2493 Boulevard
Colonial Heights, VA 23834
Phone (804) 504-5490

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22526/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/6906/brand/1/csg/1/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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1053569376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10221 KRAUSE RD UNIT 1262",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238321250",
            "telephone_number": "804-803-3334",
            "fax_number": "804-803-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2493 BOULEVARD",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342317",
            "telephone_number": "804-504-5490",
            "fax_number": "833-989-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "DAPHNE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "RN, CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-28",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "deactivation_date": "2023-03-17",
        "reactivation_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "001119792",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024164386",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024164386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.