NPIMap

Organization Active NPI

Darel C. Edwards, P.C.

Doing business as Vidalia EyeCare Center

  • Optometrist
  • Vidalia, GA
National Provider Identifier
1174706642
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1223 Issued in GA
Legal business name
DAREL C. EDWARDS, P.C.
Doing business as
Vidalia EyeCare Center
Practice address
206 Maple Dr
Vidalia, GA 30474-8907
Phone
(912) 537-2020
Fax
(912) 537-7935
NPI assigned
Dec 7, 2007
Last updated
Dec 7, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Authorized official

Name
Dr. Darel Calvin Edwards, O.D.NPI 1639162175
Title
Owner
Phone
(912) 537-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1223 GA Primary

Addresses

Primary practice location

206 Maple Dr
Vidalia, GA 30474-8907

Mailing address

206 Maple Dr
Vidalia, GA 30474-8907
Phone (912) 537-2020

Other identifiers 3

IdentifierTypeStateIssuer
1639162175OtherGANPI INDIVIDUAL
GRP3934OtherGAMEDICARE GROUP NUMBER
00423893GMedicaidGA

Other names 1

  • Vidalia EyeCare Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1174706642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 MAPLE DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748907",
            "telephone_number": "912-537-2020",
            "fax_number": "912-537-7935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 MAPLE DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748907",
            "telephone_number": "912-537-2020",
            "fax_number": "912-537-7935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAREL C. EDWARDS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-07",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "DAREL",
        "authorized_official_middle_name": "CALVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-537-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1639162175",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "GRP3934",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00423893G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vidalia EyeCare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vidalia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.