Individual provider Active NPI

Jordan Thomas Edwards, PA-C

  • Physician Assistant
  • Tucson, AZ
National Provider Identifier
1376376905
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
9525 E Old Spanish TRL Ste 101
Tucson, AZ 85748-6630
Phone
(520) 731-3666
NPI assigned
Aug 20, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

9525 E Old Spanish TRL Ste 101
Tucson, AZ 85748-6630

Mailing address

9525 E Old Spanish TRL Ste 101
Tucson, AZ 85748-6630
Phone (830) 481-3184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241016003596 AZ Practitioner - Physician Assistant 3870025752 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nextcare Arizona I JV LLCGroup PAC ID 7416393194, 297 clinicians

Practice addresses (Care Compare)

18773 S Nogales Hwy
Suite 125
Green Valley, AZ 85614-0403
Phone (520) 771-0316

4280 N Oracle Rd
Suite 100
Tucson, AZ 85705-2101
Phone (520) 887-0095

5369 S Calle Santa Cruz
Suite 145
Tucson, AZ 85706-3963
Phone (520) 573-7500

5594 E 22ND St
Tucson, AZ 85711-5523
Phone (520) 232-2047

7850 N Silverbell Rd
Suite 132
Tucson, AZ 85743-8219
Phone (520) 407-5884

9525 E Old Spanish TRL
Suite 101
Tucson, AZ 85748-6630
Phone (520) 731-3666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: jordan.edwardspac.p1@direct.nextcare.nextgenshare.com

Organizations & group practices 2

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": "1724112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1376376905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9525 E OLD SPANISH TRL STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857486630",
            "telephone_number": "830-481-3184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9525 E OLD SPANISH TRL STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857486630",
            "telephone_number": "520-731-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JORDAN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.