Individual provider Active NPI

Jacob Daniel Edwards, M.D.

  • Surgery Physician
  • Knoxville, TN
National Provider Identifier
1154700227
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
66216 Issued in TN
Practice address
1924 Alcoa Hwy
Knoxville, TN 37920-1511
Phone
(865) 670-6754
NPI assigned
May 22, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 66216 TN
Surgery Physician 208600000X 66216 TN Primary

Addresses

Primary practice location

1924 Alcoa Hwy
Knoxville, TN 37920-1511

Mailing address

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 744-2393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20220926002419 TN Practitioner - General Surgery 6608175401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Louisville School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Health System, Inc.Group PAC ID 5294646378, 512 clinicians

Practice addresses (Care Compare)

1924 Alcoa Hwy
Knoxville, TN 37920-1511

1928 Alcoa Hwy
Suite B100
Knoxville, TN 37920-1506
Phone (865) 305-6333

1928 Alcoa Hwy 102
Knoxville, TN 37920-1506
Phone (865) 305-6640

1928 Alcoa Hwy S 102
Knoxville, TN 37920-1506
Phone (865) 544-6740

1932 Alcoa Hwy
Knoxville, TN 37920-1527

2681 Andersonville Hwy
Suite 102
Clinton, TN 37716-6706
Phone (865) 494-5960

Hospital & facility affiliations

  • University Health System, Inc Hospital, Knoxville, TN, CCN 440015
  • Blount Memorial Hospital Hospital, Maryville, TN, CCN 440011

Merit-based Incentive Payment System (MIPS)

Final score
96.48 of 100Reported as apm
Quality
86.23
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66216TNMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Health System, Inc Current Accepting new patients
University Health System Inc Surgery CurrentSince Sep 1, 2022 Accepting new patients
University Health System Inc CurrentSince Sep 1, 2022 Accepting new patients

Locations

2681 Andersonville Hwy
Ste 102
Clinton, TN 37716
Phone (865) 494-5960

1924 Alcoa Hwy
Knoxville, TN 37920
Phone (865) 305-9000

1928 Alcoa Hwy
Ste B100
Knoxville, TN 37920
Phone (865) 305-6570

9000 Executive Park Dr
Ste C200
Knoxville, TN 37923
Phone (865) 670-6142

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1154700227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342818",
            "telephone_number": "252-744-2393",
            "fax_number": "252-744-3156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 ALCOA HWY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201511",
            "telephone_number": "865-670-6754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JACOB",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-22",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TN",
            "license": "66216",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "66216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.