Individual provider Active NPI

Robyn Diane Edwards

  • Student in an Organized Health Care Education/Training Program
  • Lake Havasu City, AZ
National Provider Identifier
1164212031
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2403 Dawn Dr
Lake Havasu City, AZ 86404-8505
Phone
(661) 212-4829
NPI assigned
May 12, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X AZ Primary

Addresses

Primary practice location

2403 Dawn Dr
Lake Havasu City, AZ 86404-8505

Mailing address

2403 Dawn Dr
Lake Havasu City, AZ 86404-8505
Phone (661) 212-4829

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260221001034 AZ Practitioner - Nurse Practitioner 2062993652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chestnut Health of Arizona PLLCGroup PAC ID 7517452022, 4 clinicians

Practice addresses (Care Compare)

11812 N 19TH Ave
Phoenix, AZ 85029-3536
Phone (602) 900-8828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chestnut Health of Arizona PLLC CurrentSince Jan 30, 2026 Accepting new patients

Locations

4635 N 14th St
Phoenix, AZ 85014
Phone (602) 264-9039

11812 N 19th Ave
Phoenix, AZ 85029
Phone (602) 833-4177

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1164212031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 DAWN DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864048505",
            "telephone_number": "661-212-4829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 DAWN DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864048505",
            "telephone_number": "661-212-4829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ROBYN",
        "middle_name": "DIANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.