Individual provider Active NPI

Shawn Joseph Edwards, D.C.

  • Chiropractor
  • Naples, FL
National Provider Identifier
1679534085
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH6767 Issued in FL
Practice address
3031 Airport Pulling Rd N
Naples, FL 34105-3076
Phone
(239) 659-2669
Fax
(239) 659-2639
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH6767 FL Primary

Addresses

Primary practice location

3031 Airport Pulling Rd N
Naples, FL 34105-3076

Mailing address

3031 Airport Pulling Rd N
Naples, FL 34105-3076
Phone (239) 659-2669

Other identifiers 1

IdentifierTypeStateIssuer
381895100MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050718000157 FL Practitioner - Chiropractic 0345276846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Feel Amazing Spine and Joint Institute IncGroup PAC ID 4486937208, 5 clinicians

Practice addresses (Care Compare)

3031 Airport Rd N
Naples, FL 34105-3076
Phone (239) 330-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
CH6767FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Feel Amazing Spine and Joint Institute, Inc. Chiropractor CurrentSince Jan 1, 2020 Accepting new patients
Physical Medicine Center PastSince Jun 23, 2013 Accepting new patients
Bayview Medical & Rehab Center, Inc. Past Accepting new patients
Total Orthopedic Rehabilitation, Inc Chiropractor PastSince Jul 1, 2005 Accepting new patients
Jessica J Wilson Chan D O PA PastSince Nov 3, 2019 Accepting new patients
Advanced Healthcare Alternatives Center for Integrative Medicine and Past Accepting new patients

Locations

3031 Airport Rd N
Naples, FL 34105
Phone (239) 330-1000

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431475200000",
    "number": "1679534085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 AIRPORT PULLING RD N",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341053076",
            "telephone_number": "239-659-2669",
            "fax_number": "239-659-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 AIRPORT PULLING RD N",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341053076",
            "telephone_number": "239-659-2669",
            "fax_number": "239-659-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "SHAWN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2015-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381895100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.