Active NPI
Audrey Merrick Edwards, PSYD
- Psychologist
- Las Vegas, NV
National Provider Identifier
1346318938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 01540-C
- Practice address
- 1250 S Eastern Ave
Las Vegas, NV 89104 - Phone
- (702) 474-6700
- Fax
- (702) 474-0309
- NPI assigned
- Dec 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 01540-C | NV | Primary |
Addresses
Primary practice location
1250 S Eastern Ave
Las Vegas, NV 89104
Mailing address
1250 S Eastern Ave
Las Vegas, NV 89104
Phone (702) 474-6700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140603000197 | NV | Practitioner - Clinical Social Worker | 2062447220 | Practice locations: Las Vegas, NV |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1250 S Eastern Ave
Las Vegas, NV 89104-2052
Phone (702) 474-6700
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01540-C | NV | MD | Psychologist |
| 1540 | NV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235433600000",
"number": "1346318938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 S EASTERN AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89104",
"telephone_number": "702-474-6700",
"fax_number": "702-474-0309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 S EASTERN AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89104",
"telephone_number": "702-474-6700",
"fax_number": "702-474-0309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "AUDREY",
"middle_name": "MERRICK",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2009-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NV",
"license": "01540-C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.