Individual provider Active NPI

Melissa D. Edwards, MD

  • Gynecology Physician
  • Eugene, OR
National Provider Identifier
1861422768
Registry record updated Aug 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
MD18960 Issued in OR
Practice address
590 Country Club Pkwy
Ste B
Eugene, OR 97401-6025
Phone
(541) 485-2777
Fax
(541) 246-2353
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X MD18960 OR Primary

Addresses

Primary practice location

590 Country Club Pkwy
Ste B
Eugene, OR 97401-6025

Mailing address

PO Box 70368
Springfield, OR 97475-0120
Phone (541) 485-2777

Other identifiers 1

IdentifierTypeStateIssuer
213728MedicaidOR

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD18960ORMDGynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375401600000",
    "number": "1861422768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70368",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974750120",
            "telephone_number": "541-485-2777",
            "fax_number": "541-246-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 COUNTRY CLUB PKWY",
            "address_2": "STE B",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016025",
            "telephone_number": "541-485-2777",
            "fax_number": "541-246-2353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "MELISSA",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2013-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "OR",
            "license": "MD18960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213728",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; 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.