Individual provider Active NPI

Thomas A Edwards, DO

  • Obstetrics & Gynecology Physician
  • Jacksonville, FL
National Provider Identifier
1871881201
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
05285 Issued in KY
Practice address
2005 Knight Lane BLDG H Attn; Medical Staff Services
Navy Medicine Support Command
Jacksonville, FL 32212-0140
Phone
(619) 532-6684
NPI assigned
Jul 19, 2011
Last updated
Jun 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 05285 KY Primary

Addresses

Primary practice location

2005 Knight Lane BLDG H Attn; Medical Staff Services
Navy Medicine Support Command
Jacksonville, FL 32212-0140

Mailing address

8356 Mary Dean Lane
Lakeside, CA 92040
Phone (931) 801-4941

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220713003467 KY Practitioner - Obstetrics/Gynecology 6709267313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

1023 New Moody LN
Suite 103
La Grange, KY 40031-9179
Phone (502) 222-5558

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05285KYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Obstetrics & Gynecology CurrentSince Jun 29, 2022 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jun 29, 2022 Accepting new patients
Baptist Healthcare System, Inc. Past Accepting new patients

Locations

1023 New Moody Ln
Ste 103
Lagrange, KY 40031
Phone (502) 222-5558

2400 Eastpoint Pkwy
Ste 510
Louisville, KY 40223
Phone (502) 245-4644

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

Organizations & group practices 3

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 1

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": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1871881201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8356 MARY DEAN LANE",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "92040",
            "telephone_number": "931-801-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 KNIGHT LANE BLDG H ATTN; MEDICAL STAFF SERVICES",
            "address_2": "NAVY MEDICINE SUPPORT COMMAND",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322120140",
            "telephone_number": "619-532-6684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "THOMAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-19",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KY",
            "license": "05285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.