Individual provider Active NPI

Kevin Keith Edwards

  • Obstetrics & Gynecology Physician
  • Xenia, OH
National Provider Identifier
1750676565
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
35.134175 Issued in OH
Practice address
121 S Progress Dr
Xenia, OH 45385-2673
Phone
(937) 376-9731
NPI assigned
Jun 9, 2011
Last updated
Mar 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 35.134175 OH Primary

Addresses

Primary practice location

121 S Progress Dr
Xenia, OH 45385-2673

Mailing address

3170 Kettering Blvd BLDG B3
Moraine, OH 45439-1924
Phone (937) 991-3188

Other practice location 1

2041 Georgia Ave NW
Washington, DC 20060-0001
Phone (202) 865-6100

Other identifiers 1

IdentifierTypeStateIssuer
0421915MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
RESTful URL kedwards1761199@direct.premierhealth.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201026003109 OH Practitioner - Obstetrics/Gynecology 0840610101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Morehouse School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

121 S Progress Dr
Xenia, OH 45385-2673
Phone (937) 376-9731

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
66.25
Promoting interoperability
100
Improvement activities
40
Cost
71.69

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc Obstetrics & Gynecology CurrentSince Oct 26, 2020 Accepting new patients
Premier Health Specialists Inc CurrentSince Oct 26, 2020 Accepting new patients
Miami Valley Hospital Past Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients

Locations

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

3170 Kettering Blvd
Bldg B3
Moraine, OH 45439
Phone (937) 991-3188

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

121 S Progress Dr
Xenia, OH 45385
Phone (937) 376-8336

2066 W Main St
Ste 150
Xenia, OH 45385
Phone (937) 376-9731

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1750676565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 KETTERING BLVD BLDG B3",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391924",
            "telephone_number": "937-991-3188",
            "fax_number": "937-223-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S PROGRESS DR",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453852673",
            "telephone_number": "937-376-9731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2041 Georgia Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200600001",
            "country_code": "US",
            "telephone_number": "202-865-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KEVIN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-09",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35.134175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0421915",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "kedwards1761199@direct.premierhealth.com",
            "affiliation": "N",
            "address_1": "121 S Progress Dr",
            "city": "Xenia",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453852673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Xenia, OH

Sources for this page

Verify at the official NPI Registry.