Active NPI
Kerry Ivan Edwards, M.D.
- Internal Medicine Physician
- Alachua, FL
National Provider Identifier
1114198736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME0051192
- Practice address
- 18912 NW 76TH Ave
Alachua, FL 32615-7589 - Phone
- (352) 256-3288
- Fax
- (386) 418-4335
- NPI assigned
- Mar 24, 2008
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME0051192 | FL | Primary |
Addresses
Primary practice location
18912 NW 76TH Ave
Alachua, FL 32615-7589
Mailing address
18912 NW 76TH Ave
Alachua, FL 32615-7589
Phone (352) 256-3288
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0051192 | FL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206316800000",
"number": "1114198736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18912 NW 76TH AVE",
"city": "ALACHUA",
"state": "FL",
"postal_code": "326157589",
"telephone_number": "352-256-3288",
"fax_number": "386-418-4335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18912 NW 76TH AVE",
"city": "ALACHUA",
"state": "FL",
"postal_code": "326157589",
"telephone_number": "352-256-3288",
"fax_number": "386-418-4335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "KERRY",
"middle_name": "IVAN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-24",
"last_updated": "2008-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME0051192",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alachua, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.