Nicole Yvonne Edwards, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1090 Issued in SC

Practice address

1313 Saint Andrews Rd Ste 3
Columbia, SC 29210

Phone

(803) 543-2913

Fax

(803) 708-4365

NPI assigned

Jul 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC, MO2 enrollments

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 2

Specialty

Family Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy East Ambulatory Services LLCGroup PAC ID 2365739240, 102 clinicians

Active Life Health of Columbia LLCGroup PAC ID 3577973064, 6 clinicians

Lake Regional Health SystemGroup PAC ID 9133026776, shared by 16 NPIs, 132 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lake Regional Health System Hospital, Osage Beach, MO, CCN 260186

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicole.edwards@348526823931908.direct.elationemr.com
• Direct secure messaging: nedwards@mhccaremail.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Active Life Health of Columbia, LLC

  dba Arthritis Knee Pain Centers

  • Physical Medicine & Rehabilitation Physician
  • Columbia, SC
  • NPI 1104425529
  Medicare reassignment Care Compare group NPD
• Mercy East Ambulatory Services LLC

  dba Mercy-GoHealth Urgent Care

  • Urgent Care Clinic/Center
  • Chesterfield, MO
  • NPI 1134673148
  Medicare reassignment Care Compare group NPD
• Mercy Southern Missouri Ambulatory Services LLC

  • Urgent Care Clinic/Center
  • Springfield, MO
  • NPI 1871094052
  Medicare reassignment NPD
• Active Life Health of Columbia, LLC

  dba Arthritis Knee Pain Centers

  • Durable Medical Equipment & Medical Supplies
  • Columbia, SC
  • NPI 1851990121
  NPD
• Black River Healthcare, Inc.

  dba Black River Healthcare - Manning Medical

  • Family Medicine Physician
  • Manning, SC
  • NPI 1992077424
  NPD (past)
• South Carolina Center for Intergrative Medicine

  • Family Medicine Physician
  • Columbia, SC
  • NPI 1669981429
  NPD (past)
• Lincoln County Hospital

  • Critical Access Hospital
  • Lincoln, KS
  • NPI 1942265327
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lake Regional Health System

  • Clinic/Center
  • Osage Beach, MO
  • NPI 1295151959

  Hospital

  Care Compare affiliation
• Lake Regional Health System

  • Rural Acute Care Hospital
  • Osage Beach, MO
  • NPI 1386619450
  Care Compare affiliation

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1639378987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 SAINT ANDREWS RD STE 428",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292121137",
            "telephone_number": "803-543-2913",
            "fax_number": "803-708-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 SAINT ANDREWS RD STE 3",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29210",
            "telephone_number": "803-543-2913",
            "fax_number": "803-708-4365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "612 Saint Andrews Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292105120",
            "country_code": "US",
            "telephone_number": "803-386-8684",
            "fax_number": "844-364-9446",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Palmetto Health Parkway",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "29212",
            "country_code": "US",
            "telephone_number": "803-999-1214",
            "fax_number": "803-999-1215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1722 Clarkson Rd",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630174976",
            "country_code": "US",
            "telephone_number": "636-206-2665",
            "fax_number": "636-206-2664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "NICOLE",
        "middle_name": "YVONNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "1090",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2024041698",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010909",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latoya C.T. Edwards, LPC
• Laura Edwards
• Loralyn Edwards, L.AC
• Monica Edwards
• Monica Arleen Edwards, RN
• Petra Edwards, FNP
• Rachel Aileen Edwards, MD
• Sabrina Broughton Edwards, OTR/L
• Shayleece Edwards, APRN
• Thomas Stanley Edwards, MD

• Family Medicine Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.