Individual provider Active NPI

Carl Brady Edwards, MD

  • Obstetrics & Gynecology Physician
  • Jonesboro, AR
National Provider Identifier
1265430581
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
R4353 Issued in AR
Practice address
800 S Church St
Suite 302
Jonesboro, AR 72401-4176
Phone
(870) 935-3990
Fax
(870) 935-0871
NPI assigned
Jul 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X R4353 AR Primary

Addresses

Primary practice location

800 S Church St
Suite 302
Jonesboro, AR 72401-4176

Mailing address

800 S Church St
Suite 302
Jonesboro, AR 72401-4176
Phone (870) 935-3990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20050711000695 AR Practitioner - Obstetrics/Gynecology 8022044189 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
East Tennessee State University Quillen College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Bernards Physician Clinics IncGroup PAC ID 7012311269, 211 clinicians

Practice addresses (Care Compare)

800 S Church St
Suite 302
Jonesboro, AR 72401-4107
Phone (870) 935-3990

Hospital & facility affiliations

  • St Bernards Medical Center Hospital, Jonesboro, AR, CCN 040020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R4353ARMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Bernards Physician Clinics Inc CurrentSince Aug 1, 2023 Accepting new patients
St Bernards Physician Clinics Inc CurrentSince Aug 1, 2023 Accepting new patients
St Bernards Hospital Inc. CurrentSince Aug 8, 2016 Accepting new patients
Womens Wellness Center of Northeast Arkansas, LTD. Past Accepting new patients
Stephen Rauls, MD PLLC, LLC Past Accepting new patients
Northeast Arkansas Clinic, PA Past Accepting new patients

Locations

505 E Matthews Ave
Ste 203
Jonesboro, AR 72401
Phone (870) 268-9727

1005 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 935-1242

800 S Church St
Ste 302
Jonesboro, AR 72401
Phone (501) 935-3990

1201 Fleming Ave
Jonesboro, AR 72401
Phone (870) 932-0440

Interoperability endpoints

  • Direct secure messaging: cedwards@sbpc.medalliesdirect.net

Organizations & group practices 6

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": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1265430581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S CHURCH ST",
            "address_2": "SUITE 302",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014176",
            "telephone_number": "870-935-3990",
            "fax_number": "870-935-0871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S CHURCH ST",
            "address_2": "SUITE 302",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014176",
            "telephone_number": "870-935-3990",
            "fax_number": "870-935-0871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "CARL",
        "middle_name": "BRADY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AR",
            "license": "R4353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.