Individual provider Active NPI

Kenia Imani Edwards, M.D.

  • Obstetrics & Gynecology Physician
  • San Diego, CA
National Provider Identifier
1346635430
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A161805 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
NPI assigned
Apr 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A161805 CA
Obstetrics & Gynecology Physician 207V00000X A161805 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410
Phone (858) 249-6751

Other practice location 1

315 Mercy Ave Ste 400
Merced, CA 95340-8368
Phone (209) 564-3700

Other practice location 2

1011 N China Lake Blvd
Ridgecrest, CA 93555-3130
Phone (760) 499-3640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20190926000568 CA Practitioner - Obstetrics/Gynecology 3577809102 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A161805CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Jan 19, 2023 Accepting new patients
Obhg California, P.C. Family Medicine CurrentSince Apr 25, 2022 Accepting new patients
Ridgecrest Regional Hospital Current Accepting new patients
Regents of the University of California Obstetrics & Gynecology CurrentSince Jan 19, 2023 Accepting new patients
Regents of the University of California Past Accepting new patients
Samir E. Hage, D.O., Inc. Obstetrics & Gynecology Past Accepting new patients

Locations

18300 Outer Highway 18
Apple Valley, CA 92307
Phone (760) 946-8873

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

1600 W Avenue J
Lancaster, CA 93534
Phone (661) 726-6254

4002 Vista Way
Oceanside, CA 92056
Phone (760) 724-8411

350 Terracina Blvd
Redlands, CA 92373
Phone (909) 335-5500

1011 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 499-3360

1081 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-0616

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

Interoperability endpoints

  • Direct secure messaging: keniaedwards@rrh.medalliesdirect.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1346635430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410",
            "telephone_number": "858-249-6751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 Mercy Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Merced",
            "state": "CA",
            "postal_code": "953408368",
            "country_code": "US",
            "telephone_number": "209-564-3700",
            "fax_number": "209-564-3799",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1011 N China Lake Blvd",
            "address_purpose": "LOCATION",
            "city": "Ridgecrest",
            "state": "CA",
            "postal_code": "935553130",
            "country_code": "US",
            "telephone_number": "760-499-3640",
            "fax_number": "760-499-7229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KENIA",
        "middle_name": "IMANI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A161805",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A161805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.