Individual provider Active NPI

Mary Zipporah Edwards, PA-C

  • Medical Physician Assistant
  • Monroe, NC
National Provider Identifier
1225851827
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-14759 Issued in NC
Practice address
3007 Wesley Chapel Stouts Rd
Monroe, NC 28110-4007
Phone
(704) 412-3612
NPI assigned
Nov 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-14759 NC Primary

Addresses

Primary practice location

3007 Wesley Chapel Stouts Rd
Monroe, NC 28110-4007

Mailing address

3007 Wesley Chapel Stouts Rd
Monroe, NC 28110-4007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-14759NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
SCRN LLC CurrentSince Jul 22, 2025 Accepting new patients

Locations

3007 Wesley Chapel Stouts Rd
Monroe, NC 28110
Phone (704) 412-3612

3007 Wesley Chapel Stouts Rd
Ste B
Monroe, NC 28110
Phone (704) 412-3612

Organizations & group practices 1

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": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1225851827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3007 WESLEY CHAPEL STOUTS RD",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281104007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 WESLEY CHAPEL STOUTS RD",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281104007",
            "telephone_number": "704-412-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "MARY",
        "middle_name": "ZIPPORAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-04",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-14759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

Verify at the official NPI Registry.