Amanda Gayle Edwards, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

51162 Issued in TX

Practice address

2210 Three Lakes Pkwy Ste 100
Tyler, TX 75703-0642

Phone

(903) 747-4050

NPI assigned

May 29, 2008

Last updated

Apr 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment Care Compare group NPD
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD
• Starks Medical

  • Primary Care Nurse Practitioner
  • Bullard, TX
  • NPI 1306570593
  NPD (past)

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1871751636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 THREE LAKES PKWY STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030642",
            "telephone_number": "903-747-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 THREE LAKES PKWY STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030642",
            "telephone_number": "903-747-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "AMANDA",
        "middle_name": "GAYLE",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-29",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "51162",
            "primary": true
        },
        {
            "code": "2355A2700X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Audiology Assistant",
            "state": "TX",
            "license": "51162",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billy Max Eden, MD
• Andrea Edmondson, MA CF-SLP
• Shane Lee Edmondson, PT, DPT
• Kristen Edney, APRN
• Educare Community Living Limited Partnership
• Kamesha Edwards
• Lindsey Nicole Edwards, FNP-C
• Mary Anne Edwards, FNP
• Jonathan Andrew Egly, M.D.
• Eh Home Health of East Texas, LLC (Enhabit Hospice)

• Audiologist in Tyler, TX
• Providers in Tyler, TX by specialty
• Audiologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.