Active NPI
Jared Thomas Edwards
- Pharmacist
- Irondale, AL
National Provider Identifier
1407320948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21979
- Practice address
- 1325 Montclair Rd
Irondale, AL 35210-2205 - Phone
- (205) 951-6632
- NPI assigned
- Jan 17, 2019
- Last updated
- Jul 21, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | S12380 | AL | |
| Pharmacist | 183500000X | 21979 | AL | Primary |
Addresses
Primary practice location
1325 Montclair Rd
Irondale, AL 35210-2205
Mailing address
1325 Montclair Rd
Irondale, AL 35210-2205
Phone (205) 951-6632
Other practice location 1
2316 Walker Building
Auburn, AL 36849-0001
Phone (334) 844-8938
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 |
|---|---|---|---|
| 21979 | AL | MD | Pharmacist |
| S12380 | AL | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Publix Alabama LLC | Past | Accepting new patients | |
| Publix Alabama, LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626825600000",
"number": "1407320948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1325 MONTCLAIR RD",
"city": "IRONDALE",
"state": "AL",
"postal_code": "352102205",
"telephone_number": "205-951-6632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1325 MONTCLAIR RD",
"city": "IRONDALE",
"state": "AL",
"postal_code": "352102205",
"telephone_number": "205-951-6632"
}
],
"practiceLocations": [
{
"address_1": "2316 Walker Building",
"address_purpose": "LOCATION",
"city": "Auburn",
"state": "AL",
"postal_code": "368490001",
"country_code": "US",
"telephone_number": "334-844-8938",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EDWARDS",
"first_name": "JARED",
"middle_name": "THOMAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-01-17",
"last_updated": "2021-07-21",
"certification_date": "2021-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "AL",
"license": "S12380",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "21979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irondale, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.