Jeremy Vaughan Edwards, D.O.

Primary specialty

Pediatric Hospice and Palliative Medicine PhysicianTaxonomy code 2080H0002X

License

DOS951 Issued in HI

Practice address

4494 North Palmer Road Department of Pediatrics
Bethesda, MD 20889-5001

Phone

(301) 400-3327

NPI assigned

Jul 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

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 Osteopathy

State licenses

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588377600000",
    "number": "1548269285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21320 RIDGECROFT DR",
            "city": "BROOKEVILLE",
            "state": "MD",
            "postal_code": "208331818",
            "telephone_number": "808-233-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4494 NORTH PALMER ROAD DEPARTMENT OF PEDIATRICS",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208895001",
            "telephone_number": "301-400-3327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JEREMY",
        "middle_name": "VAUGHAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2020-05-02",
        "certification_date": "2020-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "DOS951",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "HI",
            "license": "DOS951",
            "primary": false
        },
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "HI",
            "license": "DOS951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edwards Dermatology Inc
• Arden Fredeking Edwards, M.D.
• Brooke Leiman Edwards, CCC SLP
• Cassandra Edwards, LCPC
• Courtney Hannah Edwards, LCSW-C
• Joanna Tyler Edwards
• Kimberly Yvonne Edwards, M.ED.,CCC-SLP
• Michelle Marie Edwards, MD, MPH
• Polo Lynn Edwards, DPT
• Susannah Lin Edwards, MS RDN LD

• Pediatric Hospice and Palliative Medicine Physician in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Pediatric Hospice and Palliative Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2020; 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.