Active NPI
Kristan Edwards
- Pediatric Occupational Therapist
- Phoenix, AZ
National Provider Identifier
1497996755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 4299
- Practice address
- 1641 E Osborn Rd
Suite 1
Phoenix, AZ 85016-7146 - Phone
- (602) 265-4124
- NPI assigned
- Mar 17, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 4299 | AZ | Primary |
Addresses
Primary practice location
1641 E Osborn Rd
Suite 1
Phoenix, AZ 85016-7146
Mailing address
1641 E Osborn Rd
Suite 1
Phoenix, AZ 85016-7146
Phone (602) 265-4124
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 |
|---|---|---|---|
| 4299 | AZ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fiesta Pediatric Therapy | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237248000000",
"number": "1497996755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1641 E OSBORN RD",
"address_2": "SUITE 1",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850167146",
"telephone_number": "602-265-4124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1641 E OSBORN RD",
"address_2": "SUITE 1",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850167146",
"telephone_number": "602-265-4124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "KRISTAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-17",
"last_updated": "2009-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "AZ",
"license": "4299",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.