Active NPI
Bessie Deniese Edwards, EDS
- Specialist
- Citra, FL
National Provider Identifier
1235306853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 17434 NE 18TH Ave
Citra, FL 32113-0505 - Phone
- (352) 595-2542
- NPI assigned
- May 13, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
17434 NE 18TH Ave
Citra, FL 32113-0505
Mailing address
PO Box 505
17434 NE 18TH Avenue
Citra, FL 32113-0505
Phone (352) 595-2542
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 763190100 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210636800000",
"number": "1235306853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 505",
"address_2": "17434 NE 18TH AVENUE",
"city": "CITRA",
"state": "FL",
"postal_code": "321130505",
"telephone_number": "352-595-2542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17434 NE 18TH AVE",
"city": "CITRA",
"state": "FL",
"postal_code": "321130505",
"telephone_number": "352-595-2542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "BESSIE",
"middle_name": "DENIESE",
"name_prefix": "Ms.",
"credential": "EDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-13",
"last_updated": "2008-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "763190100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Citra, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.