Active NPI
Ian Edwards, PH.D.
- Psychologist
- Butler, PA
National Provider Identifier
1083911473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS016589
- Practice address
- 350 N Main St
Butler, PA 16001-4921 - Phone
- (724) 679-0747
- Fax
- (724) 287-3779
- NPI assigned
- Feb 21, 2011
- Last updated
- Feb 21, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS016589 | PA | Primary |
Addresses
Primary practice location
350 N Main St
Butler, PA 16001-4921
Mailing address
103 Hazelwood Dr
Cranberry Township, PA 16066-6857
Phone (724) 679-0747
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS016589 | PA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vocational Services | Psychologist | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/vpsdocs/r4/
Organizations & group practices 1
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": "1298246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298246400000",
"number": "1083911473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 HAZELWOOD DR",
"city": "CRANBERRY TOWNSHIP",
"state": "PA",
"postal_code": "160666857",
"telephone_number": "724-679-0747",
"fax_number": "724-287-3779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 N MAIN ST",
"city": "BUTLER",
"state": "PA",
"postal_code": "160014921",
"telephone_number": "724-679-0747",
"fax_number": "724-287-3779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "IAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-21",
"last_updated": "2011-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS016589",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Butler, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.