John Odis Edwards Jr., DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

P10129 Issued in NC

Practice address

744 Cembra Pine Dr
Fuquay Varina, NC 27526-3248

Phone

(919) 830-8730

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1922188911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 CEMBRA PINE DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275263248",
            "telephone_number": "919-830-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 CEMBRA PINE DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275263248",
            "telephone_number": "919-830-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JOHN",
        "middle_name": "ODIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P10129",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NC",
            "license": "P10129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Meghan Eivers
• Heidi Elenbaas, MS, OTR/L
• Nicole Ellington, LPC, LCAS
• Gillian Higgins Elshanawany, PA-C

• Orthopedic Physical Therapist in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• Orthopedic Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.