Scott Brian Edwards, M.D.

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

01034800A Issued in IN

Practice address

50680 Pheasant Cove Dr
Granger, IN 46530-7583

Phone

(574) 273-9947

NPI assigned

Dec 7, 2010

Last updated

Apr 25, 2014By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Connecticut General Life Insurance Company

  • Clinic/Center
  • Hammond, IN
  • NPI 1255757332
  NPD (past)

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

{
    "created_epoch": "1291680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398384000000",
    "number": "1114220589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50680 PHEASANT COVE DR",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465307583",
            "telephone_number": "574-273-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50680 PHEASANT COVE DR",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465307583",
            "telephone_number": "574-273-9947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "SCOTT",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-07",
        "last_updated": "2014-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "IN",
            "license": "01034800A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201011070",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Anthony Dunnem, RPH
• Hilary K. Dye, M.D.
• Ear, Nose and Throat of Michiana P.C. (Campbell Ear, Nose and Throat)
• Kelley Marie Edelbrock, M.A. CCC-SLP
• Melanie Jean Edmondson, ST
• Victoria R Eichorn, NP
• Elkhart Clinic, LLC
• Elkhart General Hospital, Inc. (Quality Care Pediatrics)
• Michael Eltzroth, RPH
• Elysian Corp (Elysian Center for Health and Wellness)

• Occupational Medicine Physician in Granger, IN
• Providers in Granger, IN by specialty
• Occupational Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.