Individual provider Active NPI

Timothy J Edwards, MD

  • Gastroenterology Physician
  • Cape Girardeau, MO
National Provider Identifier
1356388557
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2006010967 Issued in MO
Practice address
1429 N Mount Auburn Rd
Cape Girardeau, MO 63701-2171
Phone
(573) 334-8870
Fax
(573) 388-2310
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 2006010967 MO Primary

Addresses

Primary practice location

1429 N Mount Auburn Rd
Cape Girardeau, MO 63701-2171

Mailing address

2321 Winners Circle St
Cape Girardeau, MO 63701-1945
Phone (573) 334-8870

Other identifiers 1

IdentifierTypeStateIssuer
200980308MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20060606000059 MO Practitioner - GastroenterologyPractitioner - Internal Medicine 5597776658 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Saint Louis University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians

Practice addresses (Care Compare)

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049
Phone (573) 331-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
30 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
100

Merit-based Incentive Payment System (MIPS)

Final score
67.07 of 100Reported as apm
Quality
85.4
Promoting interoperability
0
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy285
Upper gastrointestinal (GI) endoscopy for acid reflux168

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Missouri Hospital Physicians, LLC Gastroenterology CurrentSince Jun 19, 2019 Accepting new patients
Saint Francis Medical Center Current Accepting new patients
Saint Francis Medical Center CurrentSince Aug 30, 2024 Accepting new patients
Saint Francis Medical Center CurrentSince Aug 30, 2024 Accepting new patients
Gastroenterology Associates of Southeast Mo, PC Gastroenterology CurrentSince Jul 1, 2006 Accepting new patients

Locations

28 S Mount Auburn Rd
Cape Girardeau, MO 63703
Phone (573) 331-3350

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

1429 N Mount Auburn Rd
Cpe Girardeau, MO 63701
Phone (573) 334-8870

Interoperability endpoints

  • Direct secure messaging: tedwards16019@surescripts.sfmc.net

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1356388557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2321 WINNERS CIRCLE ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637011945",
            "telephone_number": "573-334-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1429 N MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012171",
            "telephone_number": "573-334-8870",
            "fax_number": "573-388-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "2006010967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200980308",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.