Individual provider Active NPI

Joseph Lee Edison, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Auburn, AL
National Provider Identifier
1114290525
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
DO1606 Issued in AL
Practice address
349 S Donahue Dr
Auburn, AL 36849-0001
Phone
(334) 844-9821
NPI assigned
Feb 15, 2012
Last updated
Apr 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Sports Medicine (Family Medicine) Physician 207QS0010X DO1606 AL Primary

Addresses

Primary practice location

349 S Donahue Dr
Auburn, AL 36849-0001

Mailing address

349 S Donahue Dr
Auburn, AL 36849-0001
Phone (334) 844-9821

Other practice location 1

560 Devall Dr Ste 201
Auburn, AL 36832-6655
Phone (334) 887-8707

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address josephedison@apaam.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201020003591 AL Practitioner - Family PracticePractitioner - Sports Medicine 5597903153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Auburn Pediatric and Adult Medicine, L.L.C.Group PAC ID 1557452752, 18 clinicians

Practice addresses (Care Compare)

2353 Bent Creek Rd
Suite 110
Auburn, AL 36830-6482
Phone (334) 887-8707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO1606ALMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Auburn Pediatric and Adult Medicine, L.L.C. CurrentSince Sep 1, 2020 Accepting new patients

Locations

2353 Bent Creek Rd
Ste 110
Auburn, AL 36830
Phone (334) 887-8707

560 Devall Dr
Ste 201
Auburn, AL 36832
Phone (334) 209-1199

Interoperability endpoints

  • Direct secure messaging: josephedison@apaam.allscriptsdirect.net

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": "1329264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1114290525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 S DONAHUE DR",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368490001",
            "telephone_number": "334-844-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 S DONAHUE DR",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368490001",
            "telephone_number": "334-844-9821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "560 Devall Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "AL",
            "postal_code": "368326655",
            "country_code": "US",
            "telephone_number": "334-887-8707",
            "fax_number": "334-887-8706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDISON",
        "first_name": "JOSEPH",
        "middle_name": "LEE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-15",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "AL",
            "license": "DO1606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "josephedison@apaam.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "560 Devall Dr Ste 201",
            "city": "Auburn",
            "state": "AL",
            "country_code": "US",
            "postal_code": "368326655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Auburn, AL

Sources for this page

Verify at the official NPI Registry.