Penelope Edwards-Conrad, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

GA45205 Issued in GA

Practice address

2935 N Ashley St
D116
Valdosta, GA 31602-1777

Phone

(229) 244-1192

Fax

(229) 244-1195

NPI assigned

Sep 26, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Penelope Edwards Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270857600000",
    "number": "1720074602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3338 COUNTRY CLUB RD STE L",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316057425",
            "telephone_number": "229-244-1191",
            "fax_number": "229-244-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2935 N ASHLEY ST",
            "address_2": "D116",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021777",
            "telephone_number": "229-244-1192",
            "fax_number": "229-244-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS-CONRAD",
        "first_name": "PENELOPE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2010-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "GA45205",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME73941",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00813062B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENELOPE",
            "last_name": "EDWARDS",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tayler Robin Ebert, APRN. FNP-C
• Powella Samson Ebosa
• Sherrell Echols
• Hallie Eckdahl, MED/CCC-SLP
• Eric Brent Edgerton, MD
• Kelly Edwards
• Teaira Edwards
• William Daugharty Edwards Jr., PHARMD
• Edwin L. Lamb, D.M.D.,P.C.
• Brigita Eichler, DO

• Neurology Physician in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Neurology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.