Individual provider Active NPI

Stanley Owen Edwards, MD

  • Internal Medicine Physician
  • Greeley, CO
National Provider Identifier
1316907876
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
19391 Issued in CO
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

Updated by the provider on Apr 9, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
01193911MedicaidCO
ED30586OtherCOBCBS

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

LicenseStateTypeSpecialty
19391COMDInternal 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.

Verify at the official NPI Registry.