Individual provider Active NPI

Watson Allen Edwards, RN

  • Family Nurse Practitioner
  • Blacksburg, VA
National Provider Identifier
1194678367
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024197724 Issued in VA
Practice address
901 Plantation Rd Ste 1
Blacksburg, VA 24060-3880
Phone
(540) 951-0352
Fax
(540) 951-7724
NPI assigned
Feb 18, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024197724 VA Primary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 0001169217 VA

Addresses

Primary practice location

901 Plantation Rd Ste 1
Blacksburg, VA 24060-3880

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5516

Other practice location 1

434 Peppers Fry Rd NW
Christiansburg, VA 24073-5780
Phone (540) 382-6005

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001169217VAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1771372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1194678367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713",
            "telephone_number": "540-224-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 PLANTATION RD STE 1",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240603880",
            "telephone_number": "540-951-0352",
            "fax_number": "540-951-7724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "434 Peppers Fry Rd NW",
            "address_purpose": "LOCATION",
            "city": "Christiansburg",
            "state": "VA",
            "postal_code": "240735780",
            "country_code": "US",
            "telephone_number": "540-382-6005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "WATSON",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-02-18",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024197724",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001169217",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; 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.