Individual provider Active NPI

Edwin William Dennard, M.D.

  • Family Medicine Physician
  • New Orleans, LA
National Provider Identifier
1215946207
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
023064 Issued in LA
Practice address
1415 Tulane Ave
New Orleans, LA 70112-2600
Phone
(504) 988-4700
Fax
(504) 988-4701
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 023064 LA Primary

Addresses

Primary practice location

1415 Tulane Ave
New Orleans, LA 70112-2600

Mailing address

1430 Tulane Ave
#8033
New Orleans, LA 70112-2632
Phone (504) 988-4700

Other identifiers 1

IdentifierTypeStateIssuer
1557056MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100623000904 LA Practitioner - Family Practice 9537290200 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
023064LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Administrators of the Tulane Educational Fund CurrentSince Jul 26, 1999 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Jul 26, 1999 Accepting new patients
Administrators of the Tulane Education Fund PastSince Jul 31, 2023 Accepting new patients

Locations

1430 Tulane Ave
#22
New Orleans, LA 70112

1430 Tulane Ave
#8033
New Orleans, LA 70112
Phone (504) 988-4700

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1215946207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 TULANE AVE",
            "address_2": "#8033",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122632",
            "telephone_number": "504-988-4700",
            "fax_number": "504-988-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 TULANE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122600",
            "telephone_number": "504-988-4700",
            "fax_number": "504-988-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNARD",
        "first_name": "EDWIN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "023064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1557056",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.