Active NPI
Shelly Ann Edwards, ARNP
- Family Nurse Practitioner
- Ottumwa, IA
National Provider Identifier
1245671122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A078405
- Practice address
- 920 N Quincy Ave
Ottumwa, IA 52501-3866 - Phone
- (641) 455-5200
- Fax
- (641) 455-5150
- NPI assigned
- Jul 8, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A078405 | IA | Primary |
Addresses
Primary practice location
920 N Quincy Ave
Ottumwa, IA 52501-3866
Mailing address
920 N Quincy Ave
Ottumwa, IA 52501-3866
Phone (641) 455-5200
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A078405 | Other | IA | LICENSE # |
| 1245671122 | Other | IA | NPI # |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A078405 | IA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389830400000",
"number": "1245671122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 N QUINCY AVE",
"city": "OTTUMWA",
"state": "IA",
"postal_code": "525013866",
"telephone_number": "641-455-5200",
"fax_number": "641-455-5150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 N QUINCY AVE",
"city": "OTTUMWA",
"state": "IA",
"postal_code": "525013866",
"telephone_number": "641-455-5200",
"fax_number": "641-455-5150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "SHELLY",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-08",
"last_updated": "2014-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IA",
"license": "A078405",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "A078405",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI #",
"identifier": "1245671122",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ottumwa, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.