Individual provider Active NPI

Byron Clyde Edwards, PA-C, PH.D

  • Physician Assistant
  • Orem, UT
National Provider Identifier
1902887193
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1385 E 750 N
Orem, UT 84097-5480
Phone
(801) 224-5200
Fax
(801) 224-2667
NPI assigned
Nov 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1385 E 750 N
Orem, UT 84097-5480

Mailing address

257 W 400 S
Lindon, UT 84042-1760
Phone (801) 224-5639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050324000988 UT Practitioner - Physician Assistant 6406802255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Kraig Jenson PC CurrentSince Jan 1, 2005 Accepting new patients
DMB Medical PLLC Past Accepting new patients

Locations

1385 E 750 N
Orem, UT 84097
Phone (801) 224-5200

Organizations & group practices 2

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1902887193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 W 400 S",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840421760",
            "telephone_number": "801-224-5639",
            "fax_number": "801-224-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1385 E 750 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840975480",
            "telephone_number": "801-224-5200",
            "fax_number": "801-224-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "BYRON",
        "middle_name": "CLYDE",
        "name_prefix": "Mr.",
        "credential": "PA-C, PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

Verify at the official NPI Registry.