Individual provider Active NPI

Edwin Harold Waldrop Jr., N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Rutherfordton, NC
National Provider Identifier
1821185489
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0050-02616 Issued in NC
Practice address
182 W Court St
Rutherfordton, NC 28139-2805
Phone
(828) 287-7806
Fax
(828) 287-0004
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0050-02616 NC Primary

Addresses

Primary practice location

182 W Court St
Rutherfordton, NC 28139-2805

Mailing address

PO Box 878
Rutherfordton, NC 28139-0878
Phone (828) 287-7806

Other identifiers 1

IdentifierTypeStateIssuer
6113028MedicaidNC

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0050-02616NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Asthma and Allergy Center PA PastSince Jul 1, 2015 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1821185489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 878",
            "city": "RUTHERFORDTON",
            "state": "NC",
            "postal_code": "281390878",
            "telephone_number": "828-287-7806",
            "fax_number": "828-287-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 W COURT ST",
            "city": "RUTHERFORDTON",
            "state": "NC",
            "postal_code": "281392805",
            "telephone_number": "828-287-7806",
            "fax_number": "828-287-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDROP",
        "first_name": "EDWIN",
        "middle_name": "HAROLD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "0050-02616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6113028",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutherfordton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; 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.