Antonio Dessell Edwards, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12515R Issued in LA

Practice address

25073 Highway 1 S
Plaquemine, LA 70764-4431

Phone

(225) 687-1772

Fax

(225) 687-1013

NPI assigned

Jan 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Family First Medical Clinic

  • Family Medicine Physician
  • Plaquemine, LA
  • NPI 1568581213
  Authorized official Same address or phone
• Aca Clinic

  • Health Service Clinic/Center
  • Plaquemine, LA
  • NPI 1922591080
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1568515419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25073 HIGHWAY 1 S",
            "city": "PLAQUEMINE",
            "state": "LA",
            "postal_code": "707644431",
            "telephone_number": "225-687-1772",
            "fax_number": "225-687-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25073 HIGHWAY 1 S",
            "city": "PLAQUEMINE",
            "state": "LA",
            "postal_code": "707644431",
            "telephone_number": "225-687-1772",
            "fax_number": "225-687-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ANTONIO",
        "middle_name": "DESSELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "GA",
            "license": "84438",
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "LA",
            "license": "12515R",
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "GA",
            "license": "84438",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "12515R",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "84438",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "LA",
            "license": "12515R",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1534358",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Family1s@bellsouth.net",
            "affiliation": "N",
            "address_1": "25073 Highway 1 S",
            "city": "Plaquemine",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707644431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Eden Born Medical Transportation Inc
• Reita Edwards
• Kathryn C Elkins, MD
• Ella Jean McGinnis (signs & wonders community mental)
• Brandy Falcon
• Family First Medical Clinic

• Family Medicine Physician in Plaquemine, LA
• Providers in Plaquemine, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.