Kristin Edwards, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY11129 Issued in FL

Practice address

205 S Hoover Blvd Ste 204
Tampa, FL 33609-3533

Phone

(813) 419-7391

NPI assigned

Apr 8, 2019

Last updated

Oct 13, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kristin Edwards PHD LLC

  dba Tampa Pediatric Psychology

  • Clinical Psychologist
  • Tampa, FL
  • NPI 1306561592
  NPD Authorized official

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1225591266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S HOOVER BLVD STE 204",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093533",
            "telephone_number": "813-419-7391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S HOOVER BLVD STE 204",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093533",
            "telephone_number": "813-419-7391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KRISTIN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY11129",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY11129",
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Edwards, MD
• Denise K Edwards, MD
• Douglas G. Edwards, DMD
• Etheldra Renee Edwards
• Jesse Edwards
• Leetoria Edwards, ARNP
• Lenora Edwards
• Madelyne Rose Edwards
• Olivene Georgiana Edwards, CRNA
• Patricia L Edwards, M.S; CCC/SLP

• Clinical Psychologist in Tampa, FL
• Providers in Tampa, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.

Verify at the official NPI Registry.