Active NPI
Joan Patricia Edwards, MD
- Internal Medicine Physician
- Phoenix, MD
National Provider Identifier
1679653489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- D31775
- Practice address
- 9 Brocster CT
Phoenix, MD 21131-1922 - Phone
- (443) 604-6664
- NPI assigned
- Oct 16, 2006
- Last updated
- Aug 23, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | D31775 | MD | Primary |
| Hematology & Oncology Physician | 207RH0003X | D31775 | MD |
Addresses
Primary practice location
9 Brocster CT
Phoenix, MD 21131-1922
Mailing address
9 Brocster CT
Phoenix, MD 21131-1922
Phone (443) 604-6664
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W1440001 | Other | BLUE SHEILD FEDERAL | |
| 2830503006 | Other | CIGNA HEALTHCARE | |
| 41309901 | Other | BLUE C BLUE S | |
| 0498167 | Other | AETNA | |
| 370591900 | Medicaid | MD | |
| 830008489 | Other | MEDICARE RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D31775 | MD | MD | Hematology & Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250985600000",
"number": "1679653489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 BROCSTER CT",
"city": "PHOENIX",
"state": "MD",
"postal_code": "211311922",
"telephone_number": "443-604-6664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 BROCSTER CT",
"city": "PHOENIX",
"state": "MD",
"postal_code": "211311922",
"telephone_number": "443-604-6664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "JOAN",
"middle_name": "PATRICIA",
"name_prefix": "Ms.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-16",
"last_updated": "2009-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MD",
"license": "D31775",
"primary": true
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "MD",
"license": "D31775",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHEILD FEDERAL",
"identifier": "W1440001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHCARE",
"identifier": "2830503006",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE C BLUE S",
"identifier": "41309901",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0498167",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "370591900",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "830008489",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.