Ellen E. Edwards, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A8613 Issued in CA

Practice address

15025 Innovation Dr
San Diego, CA 92128-3409

Phone

(858) 806-7944

NPI assigned

Sep 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Rawi Medical PC

  • Geriatric Medicine (Internal Medicine) Physician
  • San Diego, CA
  • NPI 1942782677
  Medicare reassignment NPD
• Senior Medical Associates, Inc.

  • Geriatric Medicine (Internal Medicine) Physician
  • San Diego, CA
  • NPI 1629253505
  Medicare reassignment NPD
• Veeone Medical Group PA

  • Critical Care Medicine (Internal Medicine) Physician
  • Roseville, CA
  • NPI 1265156558
  Medicare reassignment NPD
• Scripps Clinic Medical Group

  • Multi-Specialty Clinic/Center
  • San Diego, CA
  • NPI 1124003280
  NPD (past)
• Scripps Clinic Medical Group, Inc

  • Radiation Oncology Physician
  • San Diego, CA
  • NPI 1073853180
  NPD (past)

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1245332923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-605-7836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15025 INNOVATION DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283409",
            "telephone_number": "858-806-7944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ELLEN",
        "middle_name": "E.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A8613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM",
            "identifier": "P00728795",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "020A86130",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX86130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Edwards
• Ayesha J Edwards, LCSW, BCD
• Charles Fessenden Edwards, M.D.
• Crystal L Edwards
• Dejsa Edwards, SUDRC
• Haley Elizabeth Edwards, OTD OTR/L
• Jared Ray Edwards, MD
• Jessica Edwards
• Jessica Edwards, PHARM.D.
• Joseph Edwards, IMF

• Family Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.