Organization Active NPI

Carl Edwards, MD, PLC

  • Specialist
  • Jonesboro, AR
National Provider Identifier
1356458947
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
R4353 Issued in AR
Legal business name
CARL EDWARDS, MD, PLC
Practice address
505 E Matthews Ave Ste 203
Jonesboro, AR 72401-3101
Phone
(870) 268-9727
Fax
(870) 268-9744
NPI assigned
Aug 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Authorized official

Name
Ms. Marsha Sue Speakman
Title
Office Manager
Phone
(870) 268-9727

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X R4353 AR Primary

Addresses

Primary practice location

505 E Matthews Ave Ste 203
Jonesboro, AR 72401-3101

Mailing address

505 E Matthews Ave Ste 203
Jonesboro, AR 72401-3101
Phone (870) 268-9727

Other identifiers 1

IdentifierTypeStateIssuer
123296001MedicaidAR

National Provider Directory

National Provider Directory

Locations

505 E Matthews Ave
Ste 203
Jonesboro, AR 72401
Phone (870) 268-9727

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1356458947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E MATTHEWS AVE STE 203",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013101",
            "telephone_number": "870-268-9727",
            "fax_number": "870-268-9744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E MATTHEWS AVE STE 203",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013101",
            "telephone_number": "870-268-9727",
            "fax_number": "870-268-9744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL EDWARDS, MD, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "SPEAKMAN",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-268-9727",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AR",
            "license": "R4353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123296001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.