Individual provider Active NPI

Kelle A Edwards, DC

  • Chiropractor
  • Anniston, AL
National Provider Identifier
1871602813
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1905 Issued in AL
Practice address
1105 Leighton Ave
Anniston, AL 36207-4610
Phone
(256) 741-8464
Fax
(256) 741-8465
NPI assigned
Aug 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1905 AL Primary

Addresses

Primary practice location

1105 Leighton Ave
Anniston, AL 36207-4610

Mailing address

1105 Leighton Ave
Anniston, AL 36207-4610
Phone (256) 741-8464

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040428001166 AL Practitioner - Chiropractic 7810984119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1674 Hillyer Robinson Industrial Pkwy
Oxford, AL 36203-1368
Phone (256) 741-8464

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1905ALMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Edwards Family Chiropractic, LLC Chiropractor CurrentSince Mar 1, 2018 Accepting new patients

Locations

1674 Hillyer Pkwy S
Oxford, AL 36203
Phone (256) 741-8464

1674 Hillyer Robinson Industrial Pkwy S
Oxford, AL 36203
Phone (256) 741-8464

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871602813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 LEIGHTON AVE",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362074610",
            "telephone_number": "256-741-8464",
            "fax_number": "256-741-8465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 LEIGHTON AVE",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362074610",
            "telephone_number": "256-741-8464",
            "fax_number": "256-741-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KELLE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "1905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anniston, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.