Individual provider Active NPI

Devin Lee Michael Edwards, PA-C

  • Physician Assistant
  • Corbin, KY
National Provider Identifier
1578052973
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TC714 Issued in KY
Practice address
45 Moonbow PLZ
Corbin, KY 40701
Phone
(606) 523-9010
NPI assigned
May 2, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC714 KY Primary

Addresses

Primary practice location

45 Moonbow PLZ
Corbin, KY 40701

Mailing address

PO Box 1325
Corbin, KY 40702-1325
Phone (606) 526-8131

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dedwards74620@bhkydirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20180628003083 KY Practitioner - Physician Assistant 3870849102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

1 Trillium Way
MTM/DSM
Corbin, KY 40701-8727
Phone (606) 526-4647

14662 N US Hwy 25 E
Corbin, KY 40701-6425
Phone (606) 528-1172

15 Moonbow PLZ
Corbin, KY 40701-8949
Phone (606) 528-5331

4071 Tates Creek Centre Dr
Suite 202
Lexington, KY 40517-3094
Phone (859) 260-4390

45 Moonbow PLZ
Corbin, KY 40701-8949
Phone (606) 523-9010

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Jun 1, 2018 Accepting new patients
Baptist Health Medical Group Inc Physician Assistant CurrentSince Jun 1, 2018 Accepting new patients

Locations

45 Moonbow Plz
Corbin, KY 40701
Phone (606) 523-9010

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1525219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1578052973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1325",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407021325",
            "telephone_number": "606-526-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MOONBOW PLZ",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "40701",
            "telephone_number": "606-523-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "DEVIN",
        "middle_name": "LEE MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-02",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dedwards74620@bhkydirect.com",
            "affiliation": "N",
            "address_1": "45 Moonbow Plz",
            "city": "Corbin",
            "state": "KY",
            "country_code": "US",
            "postal_code": "40701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

Verify at the official NPI Registry.