Individual provider Active NPI

Morgan Patrick Edwards, PA

  • Physician Assistant
  • Johnson City, TN
National Provider Identifier
1811495831
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
410 N State of Franklin Rd Ste 140
Johnson City, TN 37604-6972
Phone
(423) 431-2460
NPI assigned
Jan 24, 2018
Last updated
Aug 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

410 N State of Franklin Rd Ste 140
Johnson City, TN 37604-6972

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Other practice location 1

430 W Ravine Rd
Kingsport, TN 37660-3868
Phone (423) 245-3161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20180615001057 TN Practitioner - Physician Assistant 4587919519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

111 W Stone Dr
Kingsport, TN 37660-6027

400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111

410 N State of Franklin Rd
Suite 140
Johnson City, TN 37604-6972
Phone (423) 431-2460

410 N State of Franklin Rd
Suite 140B
Johnson City, TN 37604-6971
Phone (423) 431-2460

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates, Inc. CurrentSince Mar 2, 2022 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Mar 2, 2022 Accepting new patients
Associated Orthopaedics of Kingsport PC Past Accepting new patients
Blue Ridge Medical Management Corporation Physician Assistant Past Accepting new patients

Locations

1 Medical Park Blvd
Ste 300E
Bristol, TN 37620
Phone (423) 245-3161

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

410 N State of Franklin Rd
Ste 140
Johnson City, TN 37604
Phone (423) 431-2460

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

430 W Ravine Rd
Kingsport, TN 37660
Phone (423) 245-3161

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1579

Organizations & group practices 5

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 3

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": "1516752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1811495831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N STATE OF FRANKLIN RD STE 140",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046972",
            "telephone_number": "423-431-2460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "430 W Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603868",
            "country_code": "US",
            "telephone_number": "423-245-3161",
            "fax_number": "423-857-8129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "MORGAN",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-24",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.