Active NPI
Angelena B. Edwards, M.D.
- Pediatric Urology Physician
- Louisville, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Urology Physician
- License
- 59770
- Practice address
- 3999 Dutchmans LN Ste 6F
Louisville, KY 40207-4724 - Phone
- (502) 559-1670
- Fax
- (502) 349-1999
- NPI assigned
- Apr 1, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | MD-47279 | IA | |
| Pediatric Urology Physician | 2088P0231X | MD-47279 | IA | |
| Pediatric Urology Physician | 2088P0231X | 59770 | KY | Primary |
Addresses
Primary practice location
3999 Dutchmans LN Ste 6F
Louisville, KY 40207-4724
Mailing address
PO Box 776879
Chicago, IL 60677-6879
Phone (502) 588-9490
Other practice location 1
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-0748
Other practice location 2
105 E 9th St
Coralville, IA 52241-2209
Phone (319) 467-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073856860 | Medicaid | KY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://uichildrens.org/medical-services/urology | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Norton Children'S Medical Group, LLC | Current | Accepting new patients | |
| Norton Children'S Medical Group, LLC | Current | Accepting new patients | |
| Norton Children'S Medical Group, LLC | Current | Accepting new patients | |
| Norton Childrens Medical Group, LLC | Past | Accepting new patients |
Locations
601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670
3999 Dutchmans Ln
Ste 6F
Louisville, KY 40207
Phone (502) 394-1999
3999 Dutchmans Ln
Ste 6FI
Louisville, KY 40207
Interoperability endpoints
- aedwards181861@uihcdirect.org
- aedwards60362@direct.nortonhealthcare.org
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 and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721692800000",
"number": "1073856860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 776879",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606776879",
"telephone_number": "502-588-9490",
"fax_number": "502-272-5116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3999 DUTCHMANS LN STE 6F",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402074724",
"telephone_number": "502-559-1670",
"fax_number": "502-349-1999"
}
],
"practiceLocations": [
{
"address_1": "200 Hawkins Dr",
"address_purpose": "LOCATION",
"city": "Iowa City",
"state": "IA",
"postal_code": "522421009",
"country_code": "US",
"telephone_number": "319-356-0748",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "105 E 9th St",
"address_purpose": "LOCATION",
"city": "Coralville",
"state": "IA",
"postal_code": "522412209",
"country_code": "US",
"telephone_number": "319-467-2000",
"fax_number": "319-467-2410",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EDWARDS",
"first_name": "ANGELENA",
"middle_name": "B.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-01",
"last_updated": "2024-07-23",
"certification_date": "2024-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "IA",
"license": "MD-47279",
"primary": false
},
{
"code": "2088P0231X",
"taxonomy_group": "",
"desc": "Urology, Pediatric Urology",
"state": "IA",
"license": "MD-47279",
"primary": false
},
{
"code": "2088P0231X",
"taxonomy_group": "",
"desc": "Urology, Pediatric Urology",
"state": "KY",
"license": "59770",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1073856860",
"state": "KY"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://uichildrens.org/medical-services/urology",
"affiliation": "N",
"endpointDescription": "University of Iowa Department of Urology",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "200 Hawkins Dr",
"city": "Iowa City",
"state": "IA",
"country_code": "US",
"postal_code": "522421009",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.