Active NPI
Michael J Edwards Sr., MINISTER
- Homemaker
- Mesquite, TX
National Provider Identifier
1295964088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- Practice address
- 2102 Tradewind Dr
Suite 172
Mesquite, TX 75150-3309 - Phone
- (601) 810-5788
- NPI assigned
- Jul 14, 2009
- Last updated
- Jan 20, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 11
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Pastoral Counselor | 101YP1600X | |||
| Counselor | 101Y00000X | |||
| Massage Therapist | 225700000X | |||
| Acupuncturist | 171100000X | |||
| Driver | 172A00000X | |||
| Adult Companion | 372600000X | |||
| Chore Provider | 372500000X | |||
| Homemaker | 376J00000X | Primary | ||
| Religious Nonmedical Practitioner | 374K00000X | |||
| Interpreter | 171R00000X |
Addresses
Primary practice location
2102 Tradewind Dr
Suite 172
Mesquite, TX 75150-3309
Mailing address
1017 Haney Rd Ste C
Summit, MS 39666-9079
Phone (601) 810-5788
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dvine Care | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- In Home Supportive Care Agency
- Mesquite, TX
- NPI 1356676746
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327017600000",
"number": "1295964088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1017 HANEY RD STE C",
"city": "SUMMIT",
"state": "MS",
"postal_code": "396669079",
"telephone_number": "601-810-5788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2102 TRADEWIND DR",
"address_2": "SUITE 172",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751503309",
"telephone_number": "601-810-5788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "MICHAEL",
"middle_name": "J",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "MINISTER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-14",
"last_updated": "2012-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": null,
"license": null,
"primary": false
},
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": null,
"license": null,
"primary": false
},
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": false
},
{
"code": "372500000X",
"taxonomy_group": "",
"desc": "Chore Provider",
"state": null,
"license": null,
"primary": false
},
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": null,
"license": null,
"primary": true
},
{
"code": "374K00000X",
"taxonomy_group": "",
"desc": "Religious Nonmedical Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "171R00000X",
"taxonomy_group": "",
"desc": "Interpreter",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mesquite, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.