Individual provider Active NPI

Job C Edwards, PHARM D

  • Pharmacist
  • Ogdensburg, NY
National Provider Identifier
1265879654
Registry record updated May 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
I055706 Issued in NY
Practice address
908 State St
Ogdensburg, NY 13669-3348
Phone
(315) 393-1714
NPI assigned
May 27, 2013
Last updated
May 27, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X I055706 NY Primary

Addresses

Primary practice location

908 State St
Ogdensburg, NY 13669-3348

Mailing address

908 State St
Ogdensburg, NY 13669-3348

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
I055706NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1369612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369612800000",
    "number": "1265879654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 STATE ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136693348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 STATE ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136693348",
            "telephone_number": "315-393-1714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JOB",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-27",
        "last_updated": "2013-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "I055706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogdensburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.