Active NPI
James J Edwards, MD
- Family Medicine Physician
- Walla Walla, WA
National Provider Identifier
1932115169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00019832
- Practice address
- 380 Chase Ave
Convenient Care
Walla Walla, WA 99362-2924 - Phone
- (509) 522-5171
- Fax
- (509) 522-5899
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD00019832 | WA | |
| Family Medicine Physician | 207Q00000X | MD00019832 | WA | Primary |
Addresses
Primary practice location
380 Chase Ave
Convenient Care
Walla Walla, WA 99362-2924
Mailing address
PO Box 34439
Seattle, WA 98124-1439
Other practice location 1
1025 S 2nd Ave
Walla Walla, WA 99362-4116
Phone (509) 897-3000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932115169 | Medicaid | WA | |
| 150600 | Medicaid | OR |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jedwards186067@wm.providencedirect.org | Direct | |
| Direct Messaging Address | jedwards186067@wm.providencedirect.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| R & B Fleck Enterprises, LLC | Past | Accepting new patients |
Interoperability endpoints
- jedwards186067@wm.providencedirect.org
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.
-
- General Practice Physician
- Richland, WA
- NPI 1225163926
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618531200000",
"number": "1932115169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 34439",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981241439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 CHASE AVE",
"address_2": "CONVENIENT CARE",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993622924",
"telephone_number": "509-522-5171",
"fax_number": "509-522-5899"
}
],
"practiceLocations": [
{
"address_1": "1025 S 2nd Ave",
"address_purpose": "LOCATION",
"city": "Walla Walla",
"state": "WA",
"postal_code": "993624116",
"country_code": "US",
"telephone_number": "509-897-3000",
"fax_number": "509-897-5899",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EDWARDS",
"first_name": "JAMES",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2021-04-16",
"certification_date": "2021-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WA",
"license": "MD00019832",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00019832",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1932115169",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "150600",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jedwards186067@wm.providencedirect.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1025 S 2nd Ave",
"city": "Walla Walla",
"state": "WA",
"country_code": "US",
"postal_code": "993624116",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jedwards186067@wm.providencedirect.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "380 Chase Ave",
"address_2": "Convenient Care",
"city": "Walla Walla",
"state": "WA",
"country_code": "US",
"postal_code": "993622924",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Walla Walla, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.