Kenneth Lee Edwards, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

36-00-2580-E Issued in OH

Practice address

3461 Warrensville Center Road
303
Shaker Heights, OH 44122-5227

Phone

(216) 752-0727

NPI assigned

Feb 6, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1114066065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3461 WARRENSVILLE CENTER RD STE 303",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441225227",
            "telephone_number": "216-752-0727",
            "fax_number": "216-752-0727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3461 WARRENSVILLE CENTER ROAD",
            "address_2": "303",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441225227",
            "telephone_number": "216-752-0727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KENNETH",
        "middle_name": "LEE",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36-00-2580-E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0753297",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC & BS",
            "identifier": "000000116438",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jakimah R. Dye
• Ecsc III LLC
• Anita M Eddie, L.I.S.W.
• Jennifer Eddy, LSW
• Reginald M Edgerson
• Sharisse R Edwards, LPCC, LCDC-III
• Lovie Eggleston
• Katie Cheyfitz Eichenauer, LISW-S
• Barbara Lee Ekelman, PH.D.
• Faisal Elagili, M.D.

• Podiatrist in Shaker Heights, OH
• Providers in Shaker Heights, OH by specialty
• Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.