Individual provider Active NPI

David G Edwards, DPM

  • Foot & Ankle Surgery Podiatrist
  • Logan, UT
National Provider Identifier
1235125212
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
105109-0501 Issued in UT
Practice address
550 E 1400 N Ste Y
Logan, UT 84341-2407
Phone
(435) 757-6542
Fax
(800) 507-1652
NPI assigned
Sep 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 105109-0501 UT Primary

Addresses

Primary practice location

550 E 1400 N Ste Y
Logan, UT 84341-2407

Mailing address

PO Box 404
Riverton, UT 84065-0404
Phone (801) 619-2175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040406001373 UT Practitioner - Podiatry 2961495858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
David G Edwards D P M P C Foot & Ankle Surgery CurrentSince Jan 13, 2021 Accepting new patients

Locations

550 E 1400 N
Ste Y
Logan, UT 84341
Phone (435) 757-6542

1219 N 400 E
North Logan, UT 84341
Phone (435) 565-6043

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1235125212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 404",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840650404",
            "telephone_number": "801-619-2175",
            "fax_number": "877-428-7520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E 1400 N STE Y",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412407",
            "telephone_number": "435-757-6542",
            "fax_number": "800-507-1652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "DAVID",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "UT",
            "license": "105109-0501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

Verify at the official NPI Registry.