Individual provider Active NPI

Samuel Edwards, MD

  • Internal Medicine Physician
  • Lubbock, TX
National Provider Identifier
1255852505
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
S7865 Issued in TX
Practice address
3601 4TH St # Ms 9410
Lubbock, TX 79430-0002
Phone
(806) 743-3381
NPI assigned
Jun 27, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X S7865 TX Primary

Addresses

Primary practice location

3601 4TH St # Ms 9410
Lubbock, TX 79430-0002

Mailing address

3601 4TH St # Ms 9410
Lubbock, TX 79430-0002
Phone (806) 743-3381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20200819003933 TX Practitioner - Internal Medicine 0042581464 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Texas PLLCGroup PAC ID 3476688318, 685 clinicians

Practice addresses (Care Compare)

3615 19TH St
Lubbock, TX 79410-1203
Phone (806) 725-0000

Hospital & facility affiliations

  • Covenant Medical Center Hospital, Lubbock, TX, CCN 450040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
S7865TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Inpatient Physicians of Texas I, Inc Internal Medicine Current Accepting new patients
Cogent Healthcare of Texas, PA Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients
Covenant Medical Center Past Accepting new patients

Locations

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

3615 19th St
Lubbock, TX 79410
Phone (806) 725-0000

17500 W Grand Pkwy S
Sugar Land, TX 77479
Phone (281) 725-5000

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1255852505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 4TH ST # MS 9410",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002",
            "telephone_number": "806-743-3381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST # MS 9410",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002",
            "telephone_number": "806-743-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-27",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S7865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.