Active NPI
Nancy Patricia Edwards, PA-C
- Medical Physician Assistant
- Brockton, MA
National Provider Identifier
1194248559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 58
- Practice address
- 180 Centre St
Brockton, MA 02302-2733 - Phone
- (508) 586-6300
- Fax
- (508) 580-1527
- NPI assigned
- Jul 18, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 58 | MA | Primary |
Addresses
Primary practice location
180 Centre St
Brockton, MA 02302-2733
Mailing address
180 Centre St
Brockton, MA 02302-2733
Phone (508) 586-6300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 58 | Other | MA | COMMONWEALTH OF MASSACHUSETTS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58 | MA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1194248559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 CENTRE ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023022733",
"telephone_number": "508-586-6300",
"fax_number": "508-580-1527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 CENTRE ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023022733",
"telephone_number": "508-586-6300",
"fax_number": "508-580-1527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "NANCY",
"middle_name": "PATRICIA",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-18",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MA",
"license": "58",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMONWEALTH OF MASSACHUSETTS",
"identifier": "58",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.