NPIMap

Individual provider Active NPI

Joanna Edwards, MD

  • Family Medicine Physician
  • Oblong, IL
National Provider Identifier
1063947067
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.153889 Issued in IL
Practice address
1366 E 1050TH Ave
Oblong, IL 62449-2409
Phone
(618) 592-3119
Fax
(618) 546-2602
NPI assigned
Apr 27, 2017
Last updated
Dec 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.153889 IL Primary

Addresses

Primary practice location

1366 E 1050TH Ave
Oblong, IL 62449-2409

Mailing address

6626 E 75TH St
Ste 500
Indianapolis, IN 46250-2805

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201012000804 IL Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 7911276456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crawford Hospital DistrictGroup PAC ID 7719898071, 71 clinicians

Practice addresses (Care Compare)

104 N Garfield St
Oblong, IL 62449-1426
Phone (618) 592-3119

1101 N Allen St
CMH Rural Health
Robinson, IL 62454-1168
Phone (618) 544-3699

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.153889ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crawford Hospital District CurrentSince Sep 8, 2020 Accepting new patients
Crawford Hospital District CurrentSince Sep 8, 2020 Accepting new patients
Crawford Hospital District Family Medicine Current Accepting new patients
Crawford Hospital District Past Accepting new patients

Locations

1366 E 1050th Ave
Oblong, IL 62449
Phone (618) 592-3119

1000 N Allen St
Robinson, IL 62454
Phone (618) 544-3131

1002 N Allen St
Ste B
Robinson, IL 62454

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1063947067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1366 E 1050TH AVE",
            "city": "OBLONG",
            "state": "IL",
            "postal_code": "624492409",
            "telephone_number": "618-592-3119",
            "fax_number": "618-546-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JOANNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-27",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.153889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oblong, IL

Sources for this page

Verify at the official NPI Registry.