Chad Robert Edwards, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

20042553A Issued in IN

Practice address

314 W Catalpa Dr
Suite E
Mishawaka, IN 46545-3194

Phone

(574) 254-1700

Fax

(574) 254-2930

NPI assigned

Jan 11, 2012

Last updated

Feb 16, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Developmental Neuropsychological Services, P.C.

  • Clinical Neuropsychologist
  • South Bend, IN
  • NPI 1861874869
  NPD (past) Authorized official
• Psychology Associates, P.C.

  • Clinical Neuropsychologist
  • Mishawaka, IN
  • NPI 1639285232
  NPD (past)

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1487924171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10706 TRAILWOOD DR",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460386514",
            "telephone_number": "574-855-7169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 W CATALPA DR",
            "address_2": "SUITE E",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453194",
            "telephone_number": "574-254-1700",
            "fax_number": "574-254-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "CHAD",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IN",
            "license": "20042553A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karleisha Echols, RBT
• Stephen Conlon Eder, M.D.
• Ryan Edgar
• Penny Edgerly
• Caitlin Elspeth Edward, FNP-BC
• Morgan K Eichorst, PHD
• Amanda Einselen, LMHC
• Elek LLC (Foot and Ankle Clinic of Michiana)
• Gary W. Elliott, PHD
• Rita Elliott, M.A., CCC-SLP

• Clinical Neuropsychologist in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Clinical Neuropsychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.