Active NPI
Bruce Daniel Edwards III, P.T.
- Community Health Worker
- Warrenton, VA
National Provider Identifier
1366761488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 2305202896
- Practice address
- 500 Hospital Dr
Warrenton, VA 20186-3027 - Phone
- (540) 316-2680
- NPI assigned
- May 28, 2010
- Last updated
- May 28, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 2305202896 | VA | Primary |
Addresses
Primary practice location
500 Hospital Dr
Warrenton, VA 20186-3027
Mailing address
500 Hospital Dr
Warrenton, VA 20186-3027
Phone (540) 316-2680
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305202896 | VA | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275004800000",
"number": "1366761488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 HOSPITAL DR",
"city": "WARRENTON",
"state": "VA",
"postal_code": "201863027",
"telephone_number": "540-316-2680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 HOSPITAL DR",
"city": "WARRENTON",
"state": "VA",
"postal_code": "201863027",
"telephone_number": "540-316-2680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "BRUCE",
"middle_name": "DANIEL",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-28",
"last_updated": "2010-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "VA",
"license": "2305202896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warrenton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.