Active NPI
John R Edwards, MD
- Orthopaedic Surgery Physician
- Eden, NC
National Provider Identifier
1710952452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 0101-029533
- Practice address
- 520 South Van Buren Road
Suite 1
Eden, NC 27288-5019 - Phone
- (336) 627-7500
- Fax
- (336) 627-7384
- NPI assigned
- Feb 17, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 0101-029533 | VA | Primary |
Addresses
Primary practice location
520 South Van Buren Road
Suite 1
Eden, NC 27288-5019
Mailing address
P.O. Box 488
Eden, NC 27289-0488
Phone (336) 623-9711
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010242151 | Medicaid | VA | |
| 6408826 | Medicaid | VA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101-029533 | VA | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342051200000",
"number": "1710952452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 488",
"city": "EDEN",
"state": "NC",
"postal_code": "272890488",
"telephone_number": "336-623-9711",
"fax_number": "336-627-0778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 SOUTH VAN BUREN ROAD",
"address_2": "SUITE 1",
"city": "EDEN",
"state": "NC",
"postal_code": "272885019",
"telephone_number": "336-627-7500",
"fax_number": "336-627-7384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "JOHN",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-17",
"last_updated": "2012-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "VA",
"license": "0101-029533",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010242151",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6408826",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eden, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.