NPIMap

Individual provider Active NPI

Hawa J Edriss, MD

  • Pulmonary Disease Physician
  • Lexington, KY
National Provider Identifier
1841546793
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
51370 Issued in KY
Practice address
1401 Harrodsburg Rd Ste A300
Lexington, KY 40504
Phone
(859) 313-4744
Fax
(859) 276-5939
NPI assigned
Jul 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 51370 KY
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 51370 KY
Student in an Organized Health Care Education/Training Program 390200000X
Pulmonary Disease Physician 207RP1001X 51370 KY Primary

Addresses

Primary practice location

1401 Harrodsburg Rd Ste A300
Lexington, KY 40504

Mailing address

PO Box 936
London, KY 40743-0936

Other practice location 1

3601 4th St
Ms 9410
Lubbock, TX 79430-0002
Phone (806) 743-3150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180809000714 KY Practitioner - Pulmonary Disease 8224336466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Saint Joseph Dr
Lexington, KY 40504-3742
Phone (859) 313-1000

1401 Harrodsburg Rd
Lexington, KY 40504-3751
Phone (859) 276-4429

1401 Harrodsburg Rd
Suite A300
Lexington, KY 40504-3787
Phone (859) 276-4429

2750 Battlefield Memorial Hwy
Berea, KY 40403-8332
Phone (859) 968-0302

305 Estill St
Berea, KY 40403-1742
Phone (859) 986-8418

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51370KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurosurgical Associates PSC Current Accepting new patients
Kentuckyone Health Medical Group, Inc. CurrentSince Sep 1, 2018 Accepting new patients
Kentuckyone Health Medical Group, Inc. Internal Medicine CurrentSince Sep 1, 2018 Accepting new patients
Covenant Medical Group Internal Medicine Past Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients

Locations

305 Estill St
Berea, KY 40403
Phone (859) 986-1415

1401 Harrodsburg Rd
Ste C405
Lexington, KY 40504
Phone (859) 277-2280

1401 Harrodsburg Rd
Ste A300
Lexington, KY 40504
Phone (859) 313-4744

Interoperability endpoints

  • Direct secure messaging: hedriss274990@direct.stlukeshealth.org
  • Direct secure messaging: hawaedriss@kysjhspe.allscriptsdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1841546793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407430936",
            "fax_number": "606-330-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 HARRODSBURG RD STE A300",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40504",
            "telephone_number": "859-313-4744",
            "fax_number": "859-276-5939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 4th St",
            "address_2": "MS 9410",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794300002",
            "country_code": "US",
            "telephone_number": "806-743-3150",
            "fax_number": "806-743-2978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDRISS",
        "first_name": "HAWA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "51370",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "KY",
            "license": "51370",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "KY",
            "license": "51370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.