Shelise Edwards, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036-117579 Issued in IL

Practice address

235 Peachtree St NE
North Tower, Suite 2100
Atlanta, GA 30303-1401

Phone

(770) 994-9326

Fax

(770) 994-4747

NPI assigned

Nov 21, 2006

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 3

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Emergency Medicine

Education

Morehouse School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Round Table Physicians Group PLLCGroup PAC ID 0547682460, 80 clinicians

Bunker Hill Urgent Care PLLC Dba Entrust Immediate CareGroup PAC ID 6103951256, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Houston Healthcare West Hospital, Houston, TX, CCN 450644
• HCA Houston Healthcare Medical Center Hospital, Houston, TX, CCN 450659

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Bunker Hill Urgent Care PLLC Dba Entrust Immediate Care

  • Urgent Care Clinic/Center
  • Houston, TX
  • NPI 1043545940
  Medicare reassignment Care Compare group NPD
• Round Table Physicians Group PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bellaire, TX
  • NPI 1023439114
  Medicare reassignment Care Compare group NPD
• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019
  Medicare reassignment NPD
• Round Table Specialist Group, PLLC

  • Emergency Medicine Physician
  • Houston, TX
  • NPI 1497152268
  NPD
• Emerginet SRMC, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Atlanta, GA
  • NPI 1538118344
  NPD (past)
• Emerginet, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Atlanta, GA
  • NPI 1164480869
  NPD (past)
• Parkway Anesthesia Consultants, PC

  • Certified Registered Nurse Anesthetist
  • Villa Rica, GA
  • NPI 1194887455
  NPD (past)

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

• Chca West Houston L P

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1275580938
  Care Compare affiliation
• Houston - PPH, LLC

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1073043592
  Care Compare affiliation

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365379200000",
    "number": "1649345273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 PEACHTREE ST NE",
            "address_2": "NORTH TOWER, SUITE 2100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303031401",
            "telephone_number": "770-994-9326",
            "fax_number": "770-994-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 PEACHTREE ST NE",
            "address_2": "NORTH TOWER, SUITE 2100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303031401",
            "telephone_number": "770-994-9326",
            "fax_number": "770-994-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "SHELISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2013-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "GA",
            "license": "56453",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-117579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036117579-1",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036117579",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "036117579",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Naomi Edwards
• Nazaree Edwards, MD
• Samuel Edwards
• Sara Mitchell Edwards, CNM, MN, MPH
• Scott Edwards, PA
• Shorn Edwards, PA-C
• Sienna Edwards
• Susanne Hanada Edwards, RN
• Tavia Edwards
• Terri Janiece Edwards

• Emergency Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2013; 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.