Individual provider Active NPI

Sandra Ann Edwards

  • Psychiatric/Mental Health Nurse Practitioner
  • Creston, IA
National Provider Identifier
1609451632
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G162724 Issued in IA
Practice address
1003 Cottonwood Rd
Creston, IA 50801-1012
Phone
(641) 782-8457
NPI assigned
Mar 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G162724 IA Primary

Addresses

Primary practice location

1003 Cottonwood Rd
Creston, IA 50801-1012

Mailing address

1003 Cottonwood Rd
Creston, IA 50801-1012
Phone (641) 782-8457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20210423001735 IA Practitioner - Nurse Practitioner 4880002260 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Crossroads Behavioral Health ServicesGroup PAC ID 7113817933, 3 clinicians
Clarke County Public HospitalGroup PAC ID 1951219328, shared by 4 NPIs, 43 clinicians

Practice addresses (Care Compare)

405 E McLane St
Osceola, IA 50213-1592
Phone (641) 782-8457

800 S Fillmore St
Osceola, IA 50213-1694

Hospital & facility affiliations

  • Greater Regional Medical Center Hospital, Creston, IA, CCN 161365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G162724IAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clarke County Public Hospital Current Accepting new patients
Crossroads Behavioral Health Services CurrentSince May 24, 2021 Accepting new patients
Clarke County Public Hospital CurrentSince Dec 27, 2024 Accepting new patients
Clarke County Public Hospital CurrentSince Dec 27, 2024 Accepting new patients
Crossroads Behavioral Health Center PastSince Mar 16, 2021 Accepting new patients

Locations

1003 Cottonwood Rd
Creston, IA 50801
Phone (641) 782-8457

210 Russell St
Creston, IA 50801
Phone (641) 782-8457

800 S Fillmore St
Ste A
Osceola, IA 50213
Phone (641) 342-2128

800 S Fillmore St
Osceola, IA 50213
Phone (641) 342-2184

405 E McLane St
Osceola, IA 50213
Phone (641) 342-4888

Organizations & group practices 5

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": "1615420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1609451632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 COTTONWOOD RD",
            "city": "CRESTON",
            "state": "IA",
            "postal_code": "508011012",
            "telephone_number": "641-782-8457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 COTTONWOOD RD",
            "city": "CRESTON",
            "state": "IA",
            "postal_code": "508011012",
            "telephone_number": "641-782-8457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "SANDRA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-11",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G162724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Creston, IA

Sources for this page

Verify at the official NPI Registry.