Active NPI
Michael Scott Edwards
- Counselor
- Holly Hill, FL
National Provider Identifier
1780300871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- Michael Edwards
1452 Atlanta Dr
Holly Hill, FL 32117 - Phone
- (386) 274-8089
- NPI assigned
- Oct 19, 2022
- Last updated
- Oct 19, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
Michael Edwards
1452 Atlanta Dr
Holly Hill, FL 32117
Mailing address
1530 Cornerstone Blvd Ste 100
Daytona Beach, FL 32117-7129
Phone (386) 274-0341
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8004653202 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | individual | Health Information Exchange (HIE) |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666137600000",
"number": "1780300871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1530 CORNERSTONE BLVD STE 100",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321177129",
"telephone_number": "386-274-0341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MICHAEL EDWARDS",
"address_2": "1452 ATLANTA DR",
"city": "HOLLY HILL",
"state": "FL",
"postal_code": "32117",
"telephone_number": "386-274-8089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "MICHAEL",
"middle_name": "SCOTT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-10-19",
"last_updated": "2022-10-19",
"certification_date": "2022-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8004653202",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "individual",
"affiliation": "N",
"endpointDescription": "romans121314@gmail.com",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"useOtherDescription": "1452 atlanta dr",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"contentOtherDescription": "children home society",
"address_1": "1530 Cornerstone Blvd Ste 100",
"city": "Daytona Beach",
"state": "FL",
"country_code": "US",
"postal_code": "321177129",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Holly Hill, FL
- Derrick Collins LLC (stress and anxiety center)
- Wayne S Downer, LMT
- Daniel E Drake, PAC
- Brandi Lee Driggers
- Durden Consulting Services of Florida
- Elderly Living Center of Holly Hill, Inc
- Emergency Medical Foundation Inc (EVAC Ambulance)
- Lambert Harold Everson, CNA
- Faithful Caregivers,LLC
- Family Medical Practice Management, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.