Jerry Keith Edwards, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5006584 Issued in NC

Practice address

3515 W Market St Ste 200
Greensboro, NC 27403-4442

Phone

(336) 660-5520

Fax

(336) 660-5539

NPI assigned

Nov 5, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jedwards539786@direct.novanthealth.org

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.

• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group NPD
• Forsyth Memorial Hospital, Inc.

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1104548874
  Medicare reassignment NPD
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  Medicare reassignment NPD
• Forsyth Memorial Hospital Inc

  • Cardiovascular Disease Physician
  • Winston Salem, NC
  • NPI 1518252519

  Nurse Practitioner

  NPD
• Forsyth Memorial Hospital, Inc.

  • Cardiovascular Disease Physician
  • Winston Salem, NC
  • NPI 1932935475
  NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Medical Group, Inc.

  • Pediatrics Physician
  • Charlotte, NC
  • NPI 1073026019
  NPD
• Bethany Medical Center

  • Internal Medicine Physician
  • High Point, NC
  • NPI 1952404188

  Nurse Practitioner

  NPD (past)
• Novant Health Medical Group, LLC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD (past)

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1659700177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 W MARKET ST STE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274034442",
            "telephone_number": "336-660-5520",
            "fax_number": "336-660-5539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 Pee Dee Rd",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "NC",
            "postal_code": "283153817",
            "country_code": "US",
            "telephone_number": "910-944-8999",
            "fax_number": "910-944-0809",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3402 Battleground Ave",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274102404",
            "country_code": "US",
            "telephone_number": "336-883-0029 x2268",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Hickory Branch Rd",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274099601",
            "country_code": "US",
            "telephone_number": "336-878-2260",
            "fax_number": "336-878-2277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JERRY",
        "middle_name": "KEITH",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-05",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5006584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jedwards539786@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "501 Hickory Branch Rd",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274099601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brianne Edwards, MS/CCC-SLP
• Colette Marie Edwards, MA
• Elaina C Edwards
• Elizabeth Jane Edwards, MS OTR/L
• James L Edwards, MD
• Kimberly Edwards, ITFS
• Marcel Edwards
• Marva Johnson Edwards, CPSS
• Michelle Franklin Edwards, NP
• Millia Edwards

• Nurse Practitioner in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; 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.