Richard Anthony Edwards Sr.

Primary specialty

Nursing Home AdministratorTaxonomy code 376G00000X

License

374604442 Issued in CA

Practice address

423 Avocado Ave
El Cajon, CA 92020-4607

Phone

(619) 954-0963

Fax

(866) 383-1613

NPI assigned

Aug 30, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Ijt9112 and Associates LLC

  • Assisted Living Facility
  • La Mesa, CA
  • NPI 1982138996
  NPD Authorized official

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1578283669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 AVOCADO AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920204607",
            "telephone_number": "619-954-0963",
            "fax_number": "866-383-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 AVOCADO AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920204607",
            "telephone_number": "619-954-0963",
            "fax_number": "866-383-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "RICHARD",
        "middle_name": "ANTHONY",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "CA",
            "license": "374604442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "r.edwards728@gmail.com",
            "affiliation": "N",
            "address_1": "423 Avocado Ave",
            "city": "El Cajon",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920204607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Catherine Mary Eckl, LCSW
• Fernanda Edejer
• Jennifer Marie Edney
• Anna Edson
• Amanda Beth Edwards, LVN
• Anne Edwardson
• Eggleton & Langton Physical Therapy Management Services
• Nathan Ehrenberger, PTA
• Adam Eichorst
• Tyler Anne Eickholt, RN, PHN

• All providers in El Cajon, CA
• Nursing Home Administrator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.