Active NPI
Brad David Edwards, MSW
- Clinical Social Worker
- Kihei, HI
National Provider Identifier
1710124839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3896
- Practice address
- 3150 Hoomua Dr
Kihei, HI 96753-9443 - Phone
- (808) 250-7929
- NPI assigned
- Jan 12, 2009
- Last updated
- Jun 13, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | ASW #17554 | CA | |
| Clinical Social Worker | 1041C0700X | 3896 | HI | Primary |
Addresses
Primary practice location
3150 Hoomua Dr
Kihei, HI 96753-9443
Mailing address
3150 Hoomua Dr
Kihei, HI 96753-9443
Phone (808) 250-7929
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3896 | HI | MD | Pharmacist |
| ASW #17554 | CA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402617600000",
"number": "1710124839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3150 HOOMUA DR",
"city": "KIHEI",
"state": "HI",
"postal_code": "967539443",
"telephone_number": "808-250-7929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3150 HOOMUA DR",
"city": "KIHEI",
"state": "HI",
"postal_code": "967539443",
"telephone_number": "808-250-7929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "BRAD",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-12",
"last_updated": "2014-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "ASW #17554",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "HI",
"license": "3896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kihei, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.