Darrell Dewain Edwards

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2018002812 Issued in MO

Practice address

4350 S National Ave Ste C200
Springfield, MO 65810-2782

Phone

(417) 447-1000

Fax

(417) 447-6150

NPI assigned

Feb 5, 2018

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

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Citizens Memorial Healthcare

  • Surgery Physician
  • Bolivar, MO
  • NPI 1568566131

  Physician Assistant

  Medicare reassignment NPD
• Putnam Orthopaedic Center, LLC

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Springfield, MO
  • NPI 1275677023
  Medicare reassignment
• Citizens Memorial Healthcare

  dba CMH Willard Medical Center

  • Rural Health Clinic/Center
  • Willard, MO
  • NPI 1568127397
  NPD

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

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517788800000",
    "number": "1447759592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 S NATIONAL AVE STE C200",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658102782",
            "telephone_number": "417-447-1000",
            "fax_number": "417-447-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 S NATIONAL AVE STE C200",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658102782",
            "telephone_number": "417-447-1000",
            "fax_number": "417-447-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "DARRELL",
        "middle_name": "DEWAIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-05",
        "last_updated": "2018-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2018002812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Uma Kalyani Edupuganti, M.D
• Edward Gwin M.D., LLC
• Alice R Edwards, D.O.
• Christopher A. Edwards, MD
• Daniel Joseph Edwards, ATC
• Jamie Edwards, DPT
• Lauren Ashley Edwards, MS, LPC
• Sophia Y Edwards, LMSW
• Troy M. Egan, CRNA
• Anne Marsh Egbert, M.D.

• Physician Assistant in Springfield, MO
• Providers in Springfield, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.