Individual provider Active NPI

Lynnae Edwards, M.D

  • Internal Medicine Physician
  • Morrow, GA
National Provider Identifier
1902302144
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
91101 Issued in GA
Practice address
1331 Mount Zion Rd
Morrow, GA 30260-2357
Phone
(770) 629-3217
Fax
(404) 666-0085
NPI assigned
Apr 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 91101 GA Primary

Addresses

Primary practice location

1331 Mount Zion Rd
Morrow, GA 30260-2357

Mailing address

1331 Mount Zion Rd
Morrow, GA 30260-2357
Phone (770) 629-3217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20220211002095 GA Practitioner - Internal Medicine 2163769639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PMR Georgia Holding LLCGroup PAC ID 8426466590, 19 clinicians

Practice addresses (Care Compare)

1331 Mount Zion Rd
Morrow, GA 30260-2357
Phone (770) 629-3217

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
91101GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jencare Neighborhood Medical Center Morrow, LLC CurrentSince Apr 1, 2022 Accepting new patients
Jencare Neighborhood Medical Center West End, LLC PastSince Aug 4, 2014 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

1331 Mount Zion Rd
Morrow, GA 30260
Phone (404) 419-0184

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1902302144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 MOUNT ZION RD",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302602357",
            "telephone_number": "770-629-3217",
            "fax_number": "404-666-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 MOUNT ZION RD",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302602357",
            "telephone_number": "770-629-3217",
            "fax_number": "404-666-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "LYNNAE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "91101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrow, GA

Sources for this page

Verify at the official NPI Registry.