Eva Angel Edwards, APRN,FNP-BC,RFNA,CNO

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3010637 Issued in KY

Practice address

204 Town Branch Rd
Manchester, KY 40962

Phone

(606) 598-8766

Fax

(606) 598-1903

NPI assigned

Apr 24, 2007

Last updated

Sep 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Practice of Kentucky LLCGroup PAC ID 2961790167, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Family Practice of Kentucky LLC

  • Rural Health Clinic/Center
  • Manchester, KY
  • NPI 1972979540

  5% Or Greater Direct Ownership Interest

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Practice of Kentucky LLC

  • Rural Health Clinic/Center
  • Manchester, KY
  • NPI 1972979540

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD Authorized official
• Edwards Clinic, PSC

  • Rural Health Clinic/Center
  • Manchester, KY
  • NPI 1154635407

  Nurse Practitioner

  Medicare reassignment NPD

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1396964102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 TOWN BRANCH RD",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409621322",
            "telephone_number": "606-598-8766",
            "fax_number": "606-598-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 TOWN BRANCH RD",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "40962",
            "telephone_number": "606-598-8766",
            "fax_number": "606-598-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "EVA",
        "middle_name": "ANGEL",
        "name_prefix": "Mrs.",
        "credential": "APRN,FNP-BC,RFNA,CNO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3010637",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3010637",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3010637",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1090669",
            "primary": false
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "KY",
            "license": "CEP11471",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY PRACTICE OF KENTUCKY LLC",
            "identifier": "474730776",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDWARDS CLINIC PSC",
            "identifier": "611341461",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDWARDS CLINIC PSC",
            "identifier": "611341461",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100423770",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0000000280746",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cindy Dezarn, MSPT
• Diabetic Health, Inc.
• East Bernstadt Medical Clinic PLLC (Burning Springs Medical Clinic)
• Edwards Clinic, PSC
• Dana Phillip Edwards, M.D.
• Ahmed El Gammal, MD
• Kelly Evans, D.O.
• Express Care Pharmacy LLC
• Faith Medical Center LLC
• Family Clinic Manchaster LLC (Family Drug Center)

• Family Nurse Practitioner in Manchester, KY
• Providers in Manchester, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.