Jaycob Daniel Edwards, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2264 Issued in NE

Practice address

2211 S 38TH St
Lincoln, NE 68506-6024

Phone

(402) 326-3554

NPI assigned

Aug 10, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

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

Physician Assistant

Practice roles

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.

• Nebraska House Call Physicians, P.C.

  • Internal Medicine Physician
  • Lincoln, NE
  • NPI 1811931637
  Medicare reassignment
• Value Based Long Term Care B PC

  • Internal Medicine Physician
  • Lincoln, NE
  • NPI 1194498808
  NPD (past)

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1801375845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 S 38TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685066024",
            "telephone_number": "402-326-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 S 38TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685066024",
            "telephone_number": "402-326-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JAYCOB",
        "middle_name": "DANIEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-10",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "2264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trisha Edmonds
• Oluwakemi M Edokpayi, MD
• Chika Edozie
• Amy C Edwards
• Emma Sameera Edwards, P.A.
• Josie Hope Edwards
• Matthew Richard Edwards, MD
• Mindy J Edwards
• Sebastian Eugene Edwards, CRNA
• Thomas Edwards

• Medical Physician Assistant in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Medical Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; 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.