Individual provider Active NPI

Adine Edwards

  • Primary Care Nurse Practitioner
  • Springfield, OH
National Provider Identifier
1538702162
Registry record updated Oct 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
025804 Issued in OH
Practice address
100 Medical Center Dr
Springfield, OH 45504-2687
Phone
(937) 523-3100
NPI assigned
Oct 27, 2019
Last updated
Oct 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 025804 OH Primary

Addresses

Primary practice location

100 Medical Center Dr
Springfield, OH 45504-2687

Mailing address

100 Medical Center Dr
Springfield, OH 45504-2687
Phone (937) 523-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20200506001403 OH Practitioner - Nurse Practitioner 1456782523 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wright State University Boonshoft School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gcga Physicians Inc.Group PAC ID 4284618224, 76 clinicians

Practice addresses (Care Compare)

2355 Derr Rd
Suite a
Springfield, OH 45503-2439
Phone (937) 629-0100

2925 Vernon PL
Cincinnati, OH 45219-2425

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
025804OHMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Challa Ajit, M.D. LLC CurrentSince Jun 1, 2020 Accepting new patients
Gcga Physicians Inc. CurrentSince Oct 4, 2022 Accepting new patients

Locations

2925 Vernon Pl
Ste 100
Cincinnati, OH 45219
Phone (513) 872-4555

2355 Derr Rd
Ste A
Springfield, OH 45503
Phone (937) 629-0100

Interoperability endpoints

  • Direct secure messaging: adine.edwards@gastrohealth.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1572134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572134400000",
    "number": "1538702162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER DR",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455042687",
            "telephone_number": "937-523-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER DR",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455042687",
            "telephone_number": "937-523-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ADINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-27",
        "last_updated": "2019-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "025804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.