Organization Active NPI

Dr. Edwards at Wayne PC

  • Clinic/Center
  • Wayne, NJ
National Provider Identifier
1376915553
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
DR. EDWARDS AT WAYNE PC
Practice address
705 Hamburg Tpke
Wayne, NJ 07470-2098
Phone
(973) 922-1000
NPI assigned
Oct 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Authorized official

Name
Mr. Magdy Mahmoud
Title
Ceo
Phone
(973) 650-2009

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

705 Hamburg Tpke
Wayne, NJ 07470-2098

Mailing address

705 Hamburg Tpke
Wayne, NJ 07470-2098
Phone (973) 922-1000

Other identifiers 1

IdentifierTypeStateIssuer
8234400MedicaidNJ

National Provider Directory

National Provider Directory

Locations

705 Hamburg Tpke
Ste 2
Wayne, NJ 07470
Phone (973) 922-1000

705 Hamburg Tpke
Ste A
Wayne, NJ 07470
Phone (973) 922-1000

705 Hamburg Tpke
Wayne, NJ 07470
Phone (973) 904-9898

NPI Registry JSON

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445904000000",
    "number": "1376915553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 HAMBURG TPKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702098",
            "telephone_number": "973-922-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 HAMBURG TPKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702098",
            "telephone_number": "973-922-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. EDWARDS AT WAYNE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-27",
        "last_updated": "2015-10-27",
        "status": "A",
        "authorized_official_last_name": "MAHMOUD",
        "authorized_official_first_name": "MAGDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-650-2009",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8234400",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; 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.