Active NPI
Stanley Owen Edwards, MD
- Internal Medicine Physician
- Greeley, CO
National Provider Identifier
1316907876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 19391
- Practice address
- 7251 W 20TH St
Unit K
Greeley, CO 80634-4625 - Phone
- (970) 353-4322
- Fax
- (970) 353-0190
- NPI assigned
- Mar 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 19391 | CO | Primary |
| Legal Medicine | 173000000X | 19391 | CO |
Addresses
Primary practice location
7251 W 20TH St
Unit K
Greeley, CO 80634-4625
Mailing address
7251 W 20TH St
Unit K
Greeley, CO 80634-4625
Phone (970) 353-4322
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01193911 | Medicaid | CO | |
| ED30586 | Other | CO | BCBS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19391 | CO | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207699200000",
"number": "1316907876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7251 W 20TH ST",
"address_2": "UNIT K",
"city": "GREELEY",
"state": "CO",
"postal_code": "806344625",
"telephone_number": "970-353-4322",
"fax_number": "970-353-0190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7251 W 20TH ST",
"address_2": "UNIT K",
"city": "GREELEY",
"state": "CO",
"postal_code": "806344625",
"telephone_number": "970-353-4322",
"fax_number": "970-353-0190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "STANLEY",
"middle_name": "OWEN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-27",
"last_updated": "2008-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CO",
"license": "19391",
"primary": true
},
{
"code": "173000000X",
"taxonomy_group": "",
"desc": "Legal Medicine",
"state": "CO",
"license": "19391",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01193911",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "ED30586",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Greeley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.