NPIMap

Individual provider Active NPI

Raymond William Edwards, M.D.

  • Internal Medicine Physician
  • Little Rock, AR
National Provider Identifier
1851371314
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E2174 Issued in AR
Practice address
10001 Lile Dr
Little Rock, AR 72205-6217
Phone
(501) 227-8000
Fax
(501) 221-5857
NPI assigned
Jan 20, 2006
Last updated
Apr 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E2174 AR Primary

Addresses

Primary practice location

10001 Lile Dr
Little Rock, AR 72205-6217

Mailing address

10001 Lile Dr
Little Rock, AR 72205-6217
Phone (501) 227-8000

Other identifiers 4

IdentifierTypeStateIssuer
110201762OtherARRAILROAD MEDICARE
138465001MedicaidAR
5L235OtherARMEDICARE
686522OtherARMEDICARE ID# FOR CHI ST. VINCENT LITTLE ROCK DIAGNOSTIC CLINIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20100127000202 AR Practitioner - Internal MedicinePractitioner - General Practice 2466594668 Reassigns benefits to 1 organization
1 other NPI on this enrollment

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arkansas College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent Medical GroupGroup PAC ID 5698758803, 237 clinicians

Practice addresses (Care Compare)

10001 Lile Dr
Little Rock, AR 72205-6217
Phone (501) 227-8000

10301 Kanis Rd
Suite 1
Little Rock, AR 72205-6205
Phone (501) 562-4838

7709 Hwy 107
Sherwood, AR 72120-4661
Phone (501) 552-7269

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E2174ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group Internal Medicine CurrentSince Sep 1, 2018 Accepting new patients
Medical Diagnostics of LR Internal Medicine CurrentSince Jan 27, 2010 Accepting new patients

Locations

10001 Lile Dr
Little Rock, AR 72205
Phone (501) 227-8000

16221 Saint Vincent Way
Little Rock, AR 72223
Phone (501) 221-0888

Interoperability endpoints

  • Direct secure messaging: raymond.edwards.p1@direct.chi-lrdc.nextgenshare.com
  • Direct secure messaging: redwards456463@direct.stlukeshealth.org

Organizations & group practices 2

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1851371314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 LILE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056217",
            "telephone_number": "501-227-8000",
            "fax_number": "501-221-5857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 LILE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056217",
            "telephone_number": "501-227-8000",
            "fax_number": "501-221-5857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "RAYMOND",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E2174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110201762",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138465001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "5L235",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID# FOR CHI ST. VINCENT LITTLE ROCK DIAGNOSTIC CLINIC",
            "identifier": "686522",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.