NPIMap

Individual provider Active NPI

Jeanne M Edwards, MD

  • Specialist
  • Tulsa, OK
National Provider Identifier
1740223403
Registry record updated Apr 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
13708 Issued in OK
Practice address
1717-B S Utica
Suite 200
Tulsa, OK 74104
Phone
(918) 712-7900
Fax
(918) 712-9757
NPI assigned
Jun 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 13708 OK Primary

Addresses

Primary practice location

1717-B S Utica
Suite 200
Tulsa, OK 74104

Mailing address

1717-B S Utica
Suite 200
Tulsa, OK 74104
Phone (918) 712-7900

Other identifiers 1

IdentifierTypeStateIssuer
100048960BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040914000711 OK Practitioner - Neurology 0345217824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Florida College of Medicine, 1977
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1717 B S Utica Ave
Suite 200
Tulsa, OK 74104-5332
Phone (918) 712-7900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
71.83 of 100Reported as individual
Quality
43.65
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13708OKMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeanne M Edwards PC Specialist CurrentSince Nov 9, 2004 Accepting new patients
Summit Medical Center Past Accepting new patients
Springer Clinic Inc Past Accepting new patients

Locations

1717B S Utica Ave
Ste 200
Tulsa, OK 74104
Phone (918) 712-7900

Interoperability endpoints

  • Direct secure messaging: jeanne.edwards@direct.stjohnhealthsystem.com
  • Direct secure messaging: jeannemedwardspc.jeanneedwards@134277.advancedmd-direct.com

Organizations & group practices 3

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397088000000",
    "number": "1740223403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717-B S UTICA",
            "address_2": "SUITE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74104",
            "telephone_number": "918-712-7900",
            "fax_number": "918-712-9757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717-B S UTICA",
            "address_2": "SUITE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74104",
            "telephone_number": "918-712-7900",
            "fax_number": "918-712-9757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JEANNE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2014-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "13708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100048960B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.