Jacqueline Carolyn Edwards, N.P., RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN139678 Issued in GA

Practice address

8081 Tara Blvd
265
Jonesboro, GA 30236

Phone

(678) 815-5446

Fax

(188) 829-1928

NPI assigned

Dec 19, 2014

Last updated

Dec 13, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jacqueline.edwards.1@14191.direct.athenahealth.com
• Direct secure messaging: jacqueline.edwards.1@14940.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stay Home Nursing Services LLC

  • Home Health Agency
  • Hampton, GA
  • NPI 1306483581

  Registered Nurse

  NPD Authorized official
• Abc Community Services LLC

  dba Acs

  • Community Health Worker
  • Indianapolis, IN
  • NPI 1124636394
  NPD Authorized official
• Gulf Gardens Residential and Community Living LLC

  dba Ggrcl

  • Developmentally Disabled Services Day Training Agency
  • Jackson, MS
  • NPI 1831680792
  NPD Authorized official

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

{
    "created_epoch": "1418947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1740688910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8081 TARA BLVD",
            "address_2": "265",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "30236",
            "telephone_number": "678-815-5446",
            "fax_number": "188-829-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8081 TARA BLVD",
            "address_2": "265",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "30236",
            "telephone_number": "678-815-5446",
            "fax_number": "188-829-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JACQUELINE",
        "middle_name": "CAROLYN",
        "credential": "N.P., RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-19",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN139678",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71005657A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28131113A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN139678",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lashawn Ealey, CRNA
• Diana Eap
• Matthew Iredia Ebalu Jr.
• Demarco Lawayne Echols
• Rebecca Edouard, RN
• Jessica Michelle Edwards
• Elijah Health Care Solutions LLC
• Elite1St Homehealthcare
• Lois S. Emerson, PAAA
• Emory Physical Therapy, LLC

• Family Nurse Practitioner in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.