Colleen D Edge, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

R3502 Issued in TX

Practice address

8355 Walnut Hill LN Ste 105
Dallas, TX 75231-4242

Phone

(213) 368-3659

Fax

(214) 739-8923

NPI assigned

Jul 23, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Preston Hollow Pediatrics, PLLC

  • Pediatrics Physician
  • Dallas, TX
  • NPI 1679237614
  NPD Authorized official

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1215379987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8355 WALNUT HILL LN STE 105",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314242",
            "telephone_number": "213-368-3659",
            "fax_number": "214-739-8923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8355 WALNUT HILL LN STE 105",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314242",
            "telephone_number": "213-368-3659",
            "fax_number": "214-739-8923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGE",
        "first_name": "COLLEEN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2016013259",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "MO",
            "license": "2016013259",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R3502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edge-MD Hampton, PLLC
• Edge-MD Illinois, PLLC
• Edge-MD Lake June, PLLC
• Edge-MD Singleton, PLLC
• Edge-MD, PLLC
• Jeremy R Edge, LPC
• Jennifer Edgemon
• Allison Renae Edgerly, CRNA
• Linda W Edgerton, CPNP-AC
• Edie Hernandez Putt, Psy D, LPC-PC

• Pediatrics Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; 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.