Individual provider Active NPI

Eric Martin Edwards, M.D.

  • Psychiatry Physician
  • Cincinnati, OH
National Provider Identifier
1639307366
Registry record updated Dec 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35.125232 Issued in OH
Practice address
1101 Summit Rd
Cincinnati, OH 45237-2621
Phone
(513) 948-3600
Fax
(513) 948-8631
NPI assigned
Jul 1, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 125056681 IL
Psychiatry Physician 2084P0800X 35.125232 OH Primary

Addresses

Primary practice location

1101 Summit Rd
Cincinnati, OH 45237-2621

Mailing address

1101 Summit Rd
Cincinnati, OH 45237-2621
Phone (513) 948-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141223001916 OH Practitioner - Psychiatry 2264664341 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125056681ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Ohio Office of Budget and Management State Accounting CurrentSince Nov 17, 2014 Accepting new patients
State of Ohio Office of Budget and Management State Accounting CurrentSince Nov 17, 2014 Accepting new patients

Locations

1101 Summit Rd
Cincinnati, OH 45237
Phone (513) 948-3600

30 E Broad St
Fl 11
Columbus, OH 43215
Phone (614) 466-9930

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.

NPI Registry JSON

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417737600000",
    "number": "1639307366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 SUMMIT RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452372621",
            "telephone_number": "513-948-3600",
            "fax_number": "513-948-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SUMMIT RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452372621",
            "telephone_number": "513-948-3600",
            "fax_number": "513-948-8631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ERIC",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2014-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125056681",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.125232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.