Individual provider Active NPI

Chad Edwards

  • Certified Registered Nurse Anesthetist
  • Lubbock, TX
National Provider Identifier
1649631946
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28199396A Issued in IN
Practice address
3610 24TH St
Lubbock, TX 79410-2014
Phone
(806) 797-1015
Fax
(806) 771-2235
NPI assigned
Mar 14, 2016
Last updated
Mar 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 28199396A IN Primary

Addresses

Primary practice location

3610 24TH St
Lubbock, TX 79410-2014

Mailing address

3610 24TH St
Lubbock, TX 79410-2014
Phone (806) 797-1015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180803001959 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042509218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Escondido Anesthesia Associates LPGroup PAC ID 5799034518, 5 clinicians

Practice addresses (Care Compare)

488 E Valley Pkwy
Suite 110
Escondido, CA 92025-3366
Phone (760) 735-6290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
95000941CAMDPediatric Nurse Practitioner
28199396AINMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Escondido Anesthesia Associates LP Nurse Anesthetist, Certified Registered CurrentSince Jul 16, 2018 Accepting new patients

Locations

488 E Valley Pkwy
Ste 110
Escondido, CA 92025
Phone (760) 735-6290

1A Burton Hills Blvd
Nashville, TN 37215
Phone (615) 263-5579

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457913600000",
    "number": "1649631946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 24TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794102014",
            "telephone_number": "806-797-1015",
            "fax_number": "806-771-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 24TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794102014",
            "telephone_number": "806-797-1015",
            "fax_number": "806-771-2235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "CHAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-14",
        "last_updated": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28199396A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.