John Anderson Edwards, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

38917-020 Issued in WI

Practice address

130 2ND St
Neenah, WI 54956-2883

Phone

(920) 969-7900

Fax

(920) 969-7979

NPI assigned

Jul 6, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Ascension NE Wisconsin, Inc

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1407803638

  WI

  Medicare reassignment NPD
• Ascension NE Wisconsin, Inc

  • General Acute Care Hospital
  • Oshkosh, WI
  • NPI 1912527193
  NPD

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515542400000",
    "number": "1497787048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE # MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 2ND ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562883",
            "telephone_number": "920-969-7900",
            "fax_number": "920-969-7979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 E Enterprise Ave",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549137729",
            "country_code": "US",
            "telephone_number": "920-954-2551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JOHN",
        "middle_name": "ANDERSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2018-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "38917-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497787048",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• E a Darkow DDS SC
• Ear Nose and Throat Specialists of Wisconsin SC
• Ear Nose and Throat Specialists of Wisconsin, SC
• Eric G Eberts, M.D.
• Timothy R Edison, MD
• Emma Eggen, RD
• Peter Eggert
• David B Ehlert, D.D.S.
• James R Eike, D.D.S
• Justin Eisberner

• Pediatrics Physician in Neenah, WI
• Providers in Neenah, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.