Individual provider Active NPI

Rebecca E Edwards, CRNP

  • Family Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1922016658
Registry record updated May 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1096124 Issued in AL
Practice address
2470 Rocky Ridge Rd
Birmingham, AL 35243-2833
Phone
(205) 978-3336
Fax
(205) 503-4915
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1096124 AL Primary

Addresses

Primary practice location

2470 Rocky Ridge Rd
Birmingham, AL 35243-2833

Mailing address

2470 Rocky Ridge Rd
Vestavia, AL 35243-2833
Phone (205) 978-3336

Other identifiers 5

IdentifierTypeStateIssuer
630009004MedicaidAL
51514894EDWOtherALBCBS OF ALABAMA
630409102MedicaidAL
630727804OtherALTAX ID
630000004MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20071025000557 AL Practitioner - Nurse Practitioner 7517054323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2470 Rocky Ridge Rd
Vestavia, AL 35243-2894
Phone (205) 978-3336

2470 Rocky Ridge Rd
Suite 100
Birmingham, AL 35243-2833

Merit-based Incentive Payment System (MIPS)

Final score
92.5 of 100Reported as group
Quality
85
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1096124ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Dermatology and Skin Care Center of Birmingham, P.C. CurrentSince Jul 1, 2009 Accepting new patients

Locations

2470 Rocky Ridge Rd
Ste 100
Vestavia, AL 35243
Phone (205) 822-7969

2470 Rocky Ridge Rd
Vestavia, AL 35243
Phone (205) 823-1899

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.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336608000000",
    "number": "1922016658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2470 ROCKY RIDGE RD",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352432833",
            "telephone_number": "205-978-3336",
            "fax_number": "205-503-4915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 ROCKY RIDGE RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352432833",
            "telephone_number": "205-978-3336",
            "fax_number": "205-503-4915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "REBECCA",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2012-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1096124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630009004",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "51514894EDW",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630409102",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "630727804",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630000004",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.