Charles R. Edwards, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

535 Issued in OR

Practice address

822 SW Regency Ter
Portland, OR 97225-6066

Phone

(503) 243-5066

NPI assigned

Mar 11, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2014 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1173571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1649302118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7327 SW BARNES RD # 324",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256119",
            "telephone_number": "503-243-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 SW REGENCY TER",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256066",
            "telephone_number": "503-243-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "CHARLES",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-11",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "OR",
            "license": "535",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "535",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "535",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brennan J Edwards
• Brittney Elizabeth Edwards
• Bryce Edwards, M.D.
• Carrie Edwards
• Charles Freemen Edwards
• Clifton A. J. Edwards, MHA,REEGT,PMP, CPHQ
• Corey Edwards, MD
• Daniel Jay Edwards Jr., PH.D.
• Drew Edwards, NP
• Eliot Wesley Edwards, N.D.

• Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.