Active NPI
Robert James Edwards, DVM
- Prevention Professional
- Fort Irwin, CA
National Provider Identifier
1629674346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- VM13211
- Practice address
- 977 Critter Pathway
Fort Irwin, CA 92310 - Phone
- (502) 640-0349
- NPI assigned
- Dec 8, 2020
- 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 |
|---|---|---|---|---|
| Prevention Professional | 405300000X | VM13211 | FL | Primary |
Addresses
Primary practice location
977 Critter Pathway
Fort Irwin, CA 92310
Mailing address
88 Langford Lake Road
Apt 1K
Fort Irwin, CA 92310
Phone (502) 640-0349
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| VM13211 | FL | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607385600000",
"number": "1629674346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "88 LANGFORD LAKE ROAD",
"address_2": "APT 1K",
"city": "FORT IRWIN",
"state": "CA",
"postal_code": "92310",
"telephone_number": "502-640-0349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "977 CRITTER PATHWAY",
"city": "FORT IRWIN",
"state": "CA",
"postal_code": "92310",
"telephone_number": "502-640-0349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "ROBERT",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "DVM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-08",
"last_updated": "2020-12-08",
"certification_date": "2020-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "FL",
"license": "VM13211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Irwin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.