NPIMap

Individual provider Active NPI

Paul S Edwards, MD

  • Cardiovascular Disease Physician
  • Centralia, IL
National Provider Identifier
1306122163
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036129055 Issued in IL
Practice address
1050 Martin Luther King Drive
Suite 108
Centralia, IL 62801
Phone
(618) 532-3517
Fax
(618) 532-0801
NPI assigned
Oct 25, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036129055 IL Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X 82162 MN

Addresses

Primary practice location

1050 Martin Luther King Drive
Suite 108
Centralia, IL 62801

Mailing address

1050 Martin Luther King Dr Ste 108
Centralia, IL 62801-3060
Phone (618) 532-3517

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221205002548 IA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4789842527 Reassigns benefits to 1 organization
I20260528001405 MN Practitioner - Cardiovascular Disease (Cardiology) 4789842527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Medical CenterGroup PAC ID 6901706357, 91 clinicians

Practice addresses (Care Compare)

2730 Pierce St
Suite 300B
Sioux City, IA 51104-3796
Phone (712) 239-4702

402 E 2ND St
Duluth, MN 55805-1906
Phone (218) 786-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.74 of 100Reported as group
Quality
76.47
Promoting interoperability
77
Improvement activities
40
Cost
71.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036129055ILMDCardiovascular Disease Physician
82162MNMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Iowa Hospital Corporation Multi-Specialty CurrentSince Nov 14, 2022 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Naeem a Khan MD SC Multi-Specialty PastSince Jul 1, 2005 Accepting new patients

Locations

2720 Stone Park Blvd
Sioux City, IA 51104
Phone (712) 259-3000

5885 Sunnybrook Dr
Ste L200
Sioux City, IA 51106
Phone (712) 239-4702

2730 Pierce St
Ste 300B
Sioux City, IA 51104
Phone (712) 239-4702

Interoperability endpoints

  • Direct secure messaging: pedwards918653@direct.unitypoint.org

Organizations & group practices 4

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 6

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": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1306122163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 MARTIN LUTHER KING DR STE 108",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013060",
            "telephone_number": "618-532-3517",
            "fax_number": "618-532-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 MARTIN LUTHER KING DRIVE",
            "address_2": "SUITE 108",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "62801",
            "telephone_number": "618-532-3517",
            "fax_number": "618-532-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "PAUL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-25",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036129055",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MN",
            "license": "82162",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, IL

Sources for this page

Verify at the official NPI Registry.