Individual provider Active NPI

Erin K. Edwards, M.D.

  • Internal Medicine Physician
  • Kirkland, WA
National Provider Identifier
1306837463
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00037618 Issued in WA
Practice address
12910 Totem Lake Blvd NE
Suite 101
Kirkland, WA 98034-2954
Phone
(425) 814-5000
NPI assigned
Oct 28, 2005
Last updated
May 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 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 MD00037618 WA Primary

Addresses

Primary practice location

12910 Totem Lake Blvd NE
Suite 101
Kirkland, WA 98034-2954

Mailing address

12910 Totem Lake Blvd NE
Suite 101
Kirkland, WA 98034-2954
Phone (425) 814-5000

Other practice location 1

601 S Carr Rd Ste 100
Renton, WA 98055-5802
Phone (425) 227-3700

Other identifiers 1

IdentifierTypeStateIssuer
8254641MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eedwards1042798@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20100202000987 WA Practitioner - Internal Medicine 4981747748 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00037618WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacmed Clinics Internal Medicine Current Accepting new patients
Pacmed Clinics CurrentSince Oct 1, 2014 Accepting new patients
Pacmed Clinics CurrentSince Oct 1, 2014 Accepting new patients
Dynacare Northwest Inc Past Accepting new patients
Pacmed Clinics Past Accepting new patients

Locations

12910 Totem Lake Blvd NE
Kirkland, WA 98034
Phone (425) 814-5000

12910 Totem Lake Blvd NE
Ste 101
Kirkland, WA 98034
Phone (425) 814-5000

220 15th Ave SE
Puyallup, WA 98372
Phone (253) 435-3400

601 S Carr Rd
Ste 100
Renton, WA 98055
Phone (425) 227-3700

1101 Madison St
Ste 301
Seattle, WA 98104
Phone (206) 505-1101

1200 12th Ave S
Seattle, WA 98144
Phone (206) 326-2400

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1306837463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12910 TOTEM LAKE BLVD NE",
            "address_2": "SUITE 101",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980342954",
            "telephone_number": "425-814-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12910 TOTEM LAKE BLVD NE",
            "address_2": "SUITE 101",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980342954",
            "telephone_number": "425-814-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 S Carr Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980555802",
            "country_code": "US",
            "telephone_number": "425-227-3700",
            "fax_number": "425-227-3117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ERIN",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-28",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00037618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8254641",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eedwards1042798@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "601 S Carr Rd Ste 100",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980555802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.