Edwards Medical Provider Group

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

EDWARDS MEDICAL PROVIDER GROUP

Doing business as

Edwards Medical Provider Group Boulder

Practice address

1360 Walnut St Ste 104B
Boulder, CO 80302-5399

Phone

(970) 693-0015

NPI assigned

Nov 28, 2023

Organization subpart

Yes

Parent organization

EDWARDS MEDICAL PROVIDER GROUPAs reported in NPPES

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

Authorized official

Name

Ashley Blair Elder, PHD

Title

Revenue Cycle Administrator

Phone

(737) 247-1223

Specialties & licenses 1

Addresses

Other names 1

• Edwards Medical Provider Group Boulder Doing business as

Tax ID family

Edwards Medical Provider Group3 organizations share this tax ID, including this one

Part of

Edwards Medical Provider Group

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Edwards Medical Provider Group

  • Multi-Specialty Clinic/Center
  • Aurora, CO
  • NPI 1427711829
  NPD tax ID
• Edwards Medical Provider Group

  • Multi-Specialty Clinic/Center
  • Edwards, CO
  • NPI 1619573904
  NPD tax ID

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706227200000",
    "number": "1801662135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 CORDILLERA WAY",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816326290",
            "telephone_number": "737-247-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 WALNUT ST STE 104B",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025399",
            "telephone_number": "970-693-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARDS MEDICAL PROVIDER GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EDWARDS MEDICAL PROVIDER GROUP",
        "enumeration_date": "2023-11-28",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A",
        "authorized_official_last_name": "ELDER",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "BLAIR",
        "authorized_official_title_or_position": "REVENUE CYCLE ADMINISTRATOR",
        "authorized_official_telephone_number": "737-247-1223",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edwards Medical Provider Group Boulder",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Edwards Medical Provider Group Boulder",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Monica Edlauer, MSOM, LAC
• Blake Edmond
• Lisa A Edmonds, OT
• Edward E Barrett DDS
• Edward Mockus PHD PLLC (Boulder Center for Family and Behavioral Health)
• Elizabeth Claire Edwards, OT
• Rachel Marie Edwards, PA-C
• Scarlett Edwards
• Sean Edwards
• Marina Frances Efstathiu

• Multi-Specialty Clinic/Center in Boulder, CO
• Providers in Boulder, CO by specialty
• Multi-Specialty Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.