Jamal Rashawn Edwards, PT, DPT, ATC, CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P21497 Issued in NC

Practice address

2301 Erwin Rd
Durham, NC 27710-2111

Phone

(919) 684-8111

NPI assigned

Jul 12, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

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 and National Provider Directory roles.

• Ohsu Outpatient Clinical Services LLC

  • Physiological Laboratory
  • Portland, OR
  • NPI 1194568469
  NPD
• Ohsu Outpatient Clinical Services LLC

  • General Practice Physician
  • Beaverton, OR
  • NPI 1336824440
  NPD

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1891217709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3806 UNIVERSITY DR APT 234",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076880",
            "telephone_number": "317-937-7518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 ERWIN RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277102111",
            "telephone_number": "919-684-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JAMAL",
        "middle_name": "RASHAWN",
        "credential": "PT, DPT, ATC, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-12",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bathai Ishmael Elijah Edwards, MD
• Christopher Edwards, PHD
• Daniel Edwards
• Drake Scott Edwards, MD, PHD
• Frances Leigh Andersen Edwards, LCSW
• Jennifer Smith Edwards, LPC
• Joi Lashawn Edwards, DPT
• Jonathan Edwards, LAC
• Kelly Gardner Edwards, RN, MSN, FNP/WHNP-BC
• Kyle Edwards, DPT

• Physical Therapist in Durham, NC
• Providers in Durham, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.