NPIMap

Individual provider Active NPI

Jeffery D Edwards, M.D.

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1518288604
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P5971 Issued in TX
Practice address
3600 Gaston Ave
Dallas, TX 75246-1800
Phone
(214) 821-8867
NPI assigned
Jun 12, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DR.0072734 CO
Internal Medicine Physician 207R00000X P5971 TX Primary

Addresses

Primary practice location

3600 Gaston Ave
Dallas, TX 75246-1800

Mailing address

9021 Westglen Dr
Dallas, TX 75228-4124
Phone (972) 824-1386

Other practice location 1

1400 E Boulder St Ste 2508
Colorado Springs, CO 80909-5533
Phone (719) 365-1292

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jedwards262337@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130711000281 TX Practitioner - Internal Medicine 5890935050 Reassigns benefits to 1 organization
I20240612003517 CO Practitioner - HospitalistPractitioner - Internal Medicine 5890935050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1400 E Boulder St
Suite 2508
Colorado Springs, CO 80909-5533
Phone (719) 365-6999

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Nov 1, 2018 Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients
Healthtexas Provider Network Internal Medicine CurrentSince Nov 1, 2018 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jul 29, 2024 Accepting new patients
Uch-MHS Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1400 E Boulder St
Ste 2508
Colorado Springs, CO 80909
Phone (719) 365-1292

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

3600 Gaston Ave
Ste 550
Dallas, TX 75246
Phone (214) 821-1177

3600 Gaston Ave
Dallas, TX 75246
Phone (214) 820-7246

3600 Gaston Ave
Ste 558
Dallas, TX 75246

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

700 Walter Reed Blvd
Ste 203
Garland, TX 75042
Phone (972) 426-9900

Interoperability endpoints

  • Direct secure messaging: jedwards262337@direct.sw.org

Organizations & group practices 5

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.

Hospital & facility affiliations 25

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1276300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1518288604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9021 WESTGLEN DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752284124",
            "telephone_number": "972-824-1386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461800",
            "telephone_number": "214-821-8867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 E Boulder St Ste 2508",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809095533",
            "country_code": "US",
            "telephone_number": "719-365-1292",
            "fax_number": "719-365-6997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JEFFERY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-12",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0072734",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P5971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jedwards262337@direct.sw.org",
            "affiliation": "N",
            "address_1": "3600 Gaston Ave",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752461800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.