Fred Clayton Edge, DC,MD

Key facts

NPI

1902943541

Entity type

Individual (NPI type 1)

Primary specialty

Chiropractor 111N00000X

License

DC001569L (PA)

Practice address

1829 University Dr
Dunbar, PA 15431-2050

Phone

(724) 628-6677

Fax

(724) 628-4611

NPI assigned

Jan 31, 2007

Sex

Male

Sole proprietor

No

Organizations & group practices 1

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.

• Butler Ave NC Chiropractic Center PC Chiropractor · Dunbar, PA · NPI 1871728428
  NPD (past) CHIROPRACTOR

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 11, 2025.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1902943541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1829 UNIVERSITY DR",
            "city": "DUNBAR",
            "state": "PA",
            "postal_code": "154312050",
            "telephone_number": "724-628-6677",
            "fax_number": "724-628-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1829 UNIVERSITY DR",
            "city": "DUNBAR",
            "state": "PA",
            "postal_code": "154312050",
            "telephone_number": "724-628-6677",
            "fax_number": "724-628-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGE",
        "first_name": "FRED",
        "middle_name": "CLAYTON",
        "credential": "DC,MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC001569L",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD039571L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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