Individual provider Active NPI

Martha J Edwards, LCSW

  • Clinical Social Worker
  • Richmond, VA
National Provider Identifier
1104121284
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904006649 Issued in VA
Practice address
5875 Bremo Rd
Suiteg-5
Richmond, VA 23226-1934
Phone
(804) 287-7840
Fax
(804) 287-7845
NPI assigned
Jan 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904006649 VA Primary

Addresses

Primary practice location

5875 Bremo Rd
Suiteg-5
Richmond, VA 23226-1934

Mailing address

5875 Bremo Rd
Suiteg-5
Richmond, VA 23226-1934
Phone (804) 287-7840

Other identifiers 1

IdentifierTypeStateIssuer
C06778OtherVAGROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110330001010 VA Practitioner - Clinical Social Worker 4385827278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8900 Three Chopt Rd
Suite C
Richmond, VA 23229-4615
Phone (804) 564-4095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904006649VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
M J Edwards LLC Clinical CurrentSince Nov 1, 2018 Accepting new patients
Bon Secours-St. Mary'S Hospital of Richmond, Inc. Past Accepting new patients
Bon Secours-St. Mary'S Hospital of Richmond, Inc. Past Accepting new patients

Locations

8900 Three Chopt Rd
Ste C
Richmond, VA 23229
Phone (804) 564-4095

Organizations & group practices 3

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": "1295481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1104121284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5875 BREMO RD",
            "address_2": "SUITEG-5",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261934",
            "telephone_number": "804-287-7840",
            "fax_number": "804-287-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 BREMO RD",
            "address_2": "SUITEG-5",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261934",
            "telephone_number": "804-287-7840",
            "fax_number": "804-287-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "MARTHA",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-20",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06778",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.