Active NPI
Wilson Barton Edwards Jr., M.D.
- Forensic Psychiatry Physician
- Panama City, FL
National Provider Identifier
1588692446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychiatry Physician
- License
- ME65288
- Practice address
- 1607 Lisenby Ave
Suite D
Panama City, FL 32405-3796 - Phone
- (850) 250-3360
- Fax
- (850) 640-3798
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychiatry Physician | 2084F0202X | ME65288 | FL | Primary |
Addresses
Primary practice location
1607 Lisenby Ave
Suite D
Panama City, FL 32405-3796
Mailing address
1607 Lisenby Ave
Suite D
Panama City, FL 32405-3796
Phone (850) 250-3360
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 1, 2019 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME65288 | FL | MD | Forensic Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489536000000",
"number": "1588692446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1607 LISENBY AVE",
"address_2": "SUITE D",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324053796",
"telephone_number": "850-250-3360",
"fax_number": "850-640-3798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1607 LISENBY AVE",
"address_2": "SUITE D",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324053796",
"telephone_number": "850-250-3360",
"fax_number": "850-640-3798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "WILSON",
"middle_name": "BARTON",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2017-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "2084F0202X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Forensic Psychiatry",
"state": "FL",
"license": "ME65288",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Panama City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.