NPIMap

Individual provider Active NPI

Brandon Cole Edwards, NP-C

  • Nurse Practitioner
  • Eldorado, IL
National Provider Identifier
1245840636
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.021668 Issued in IL
Practice address
1600 Crossroad School Rd
Eldorado, IL 62930-3142
Phone
(618) 499-2941
NPI assigned
Jul 31, 2020
Last updated
Apr 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.021668 IL Primary
Family Nurse Practitioner 363LF0000X 209.021668 IL

Addresses

Primary practice location

1600 Crossroad School Rd
Eldorado, IL 62930-3142

Mailing address

1600 Crossroad School Rd
Eldorado, IL 62930-3142
Phone (618) 499-2941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210505001722 IL Practitioner - Nurse Practitioner 8022427921 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Statera Health Care LLCGroup PAC ID 0244565729, 41 clinicians
Trinity Medical Staffing LLCGroup PAC ID 1759712698, 35 clinicians
Eldorado Emergency Group PCGroup PAC ID 3678955028, 14 clinicians
Franklin Hospital DistrictGroup PAC ID 4082516042, shared by 5 NPIs, 32 clinicians

Practice addresses (Care Compare)

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946-2718
Phone (618) 253-7671

1201 Pine St
Eldorado, IL 62930-1634
Phone (618) 273-3361

201 Bailey LN
Benton, IL 62812-1969
Phone 6184393161332

3333 W Deyoung St
Marion, IL 62959-5884
Phone (618) 998-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.25 of 100Reported as group
Quality
100
Improvement activities
40
Cost
73.66

Merit-based Incentive Payment System (MIPS)

Final score
77.51 of 100Reported as group
Quality
49.04
Promoting interoperability
95
Improvement activities
40
Cost
69.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.021668ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Statera Health Care, LLC CurrentSince May 1, 2021 Accepting new patients
Franklin Hospital District CurrentSince May 1, 2021 Accepting new patients
Morrison Community Hospital District Current Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. Nurse Practitioner CurrentSince May 1, 2024 Accepting new patients
Eldorado Emergency Group PC Nurse Practitioner CurrentSince Mar 10, 2024 Accepting new patients
Franklin Hospital District Family CurrentSince May 1, 2021 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. Nurse Practitioner CurrentSince May 1, 2024 Accepting new patients
Granite City Hospitalist Services LLC CurrentSince Dec 1, 2021 Accepting new patients
Franklin Hospital District Current Accepting new patients
Trinity Medical Staffing LLC CurrentSince May 1, 2021 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. Nurse Practitioner Current Accepting new patients
Deaconess Illinois Clinic, Inc Past Accepting new patients

Locations

201 Bailey Ln
Benton, IL 62812
Phone (618) 438-3113

2250 N Illinois Ave
Carbondale, IL 62901
Phone (618) 833-1691

1201 Pine St
Eldorado, IL 62930
Phone (618) 273-3361

2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946
Phone (618) 252-4956

303 S Commercial St
Harrisburg, IL 62946
Phone (618) 767-6050

3333 W Deyoung St
Marion, IL 62959
Phone (618) 998-7020

611 S Marshall Ave
Mc Leansboro, IL 62859
Phone (618) 542-2146

303 N Jackson St
Morrison, IL 61270
Phone (815) 772-4003

8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500

Interoperability endpoints

  • Direct secure messaging: bedwards@yourcarecommunity.org
  • Direct secure messaging: bedwards333983@direct.deaconess.com
  • Direct secure messaging: bedwards8258@sih.direct-ci.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1596153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1245840636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 CROSSROAD SCHOOL RD",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629303142",
            "telephone_number": "618-499-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CROSSROAD SCHOOL RD",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629303142",
            "telephone_number": "618-499-2941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "BRANDON",
        "middle_name": "COLE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-31",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.021668",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.021668",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldorado, IL

Sources for this page

Verify at the official NPI Registry.