Tamyra Edwards, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY004399 Issued in GA

Practice address

104 Bombay LN Ste B
Roswell, GA 30076-5814

Phone

(678) 824-7733

NPI assigned

Jan 20, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Magnolia Wellness & Psychology, LLC

  • Clinical Psychologist
  • Lawrenceville, GA
  • NPI 1740919711
  NPD Authorized official
• Magnolia Wellness Solutions LLC

  • Clinical Psychologist
  • Lawrenceville, GA
  • NPI 1629670922
  NPD

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1235729633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 BOMBAY LN STE B",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765814",
            "telephone_number": "678-824-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 BOMBAY LN STE B",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765814",
            "telephone_number": "678-824-7733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Elephant Trl",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013016",
            "country_code": "US",
            "telephone_number": "770-535-1050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "TAMYRA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-20",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY004399",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY004399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward J Furey OD PC
• Corrinna Monique Edwards, CPM
• Emily Catherine Edwards, OT
• Krista Edwards
• Robin Jeanise Edwards, FNP-C
• Tiffany Cherell Edwards
• Andrea Kristin Eggleston
• Erica A Egnor, M.ED., BCBA
• Ehi Clinical Study Research Center, LLC.
• Ehi Pharmacy Solutions, LLC.

• Psychologist in Roswell, GA
• Providers in Roswell, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.