John T Edwards, ST

Primary specialty

Radiologic TechnologistTaxonomy code 247100000X

License

PTR1913 Issued in AZ

Practice address

14506 W Granite Valley Dr
Suite 205
Sun City West, AZ 85375-6010

Phone

(623) 584-5626

Fax

(623) 584-8998

NPI assigned

Feb 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376686261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14506 W GRANITE VALLEY DR",
            "address_2": "SUITE 205",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853756010",
            "telephone_number": "623-584-5626",
            "fax_number": "623-584-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14506 W GRANITE VALLEY DR",
            "address_2": "SUITE 205",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853756010",
            "telephone_number": "623-584-5626",
            "fax_number": "623-584-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JOHN",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "ST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "AZ",
            "license": "PTR1913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Sun City West, AZ
• Radiologic Technologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.