Laquita Edwards, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4619-23 Issued in WI

Practice address

2555 N Dr Martin Luther King Dr
Milwaukee, WI 53212-2709

Phone

(414) 372-8080

Fax

(414) 372-1893

NPI assigned

Jan 12, 2015

Sex

Female

Sole proprietor

No

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

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ledwards526469@direct.ochin.org

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.

• Milwaukee Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1518005818
  Medicare reassignment NPD (past)
• Milwaukee Health Services Inc

  • Case Management Agency
  • Milwaukee, WI
  • NPI 1346657442
  NPD

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

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1164811394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 N DR MARTIN LUTHER KING JR DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122709",
            "telephone_number": "414-372-8080",
            "fax_number": "414-372-7425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 N DR MARTIN LUTHER KING DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122709",
            "telephone_number": "414-372-8080",
            "fax_number": "414-372-1893"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8200 W Silver Spring Dr",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532182552",
            "country_code": "US",
            "telephone_number": "414-760-3900",
            "fax_number": "414-464-7859",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "636 S River Rd",
            "address_2": "Suite 303",
            "address_purpose": "LOCATION",
            "city": "Des Plaines",
            "state": "IL",
            "postal_code": "600164624",
            "country_code": "US",
            "telephone_number": "842-882-2030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "LAQUITA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-12",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4619-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100085809",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda Edwards, MSE
• Chrystal Edwards, CNM
• Darrell Delmar Edwards I, SAC-IT
• Elizabeth A. Edwards, PA-C
• Jeffrey W Edwards, PA
• Lisa Edwards, RN
• Patricia A Edwards, 14032-132
• Roshay Michelle Edwards
• Sabrina Edwards, RN
• Shawn Edwards

• Physician Assistant in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.