Individual provider Active NPI

James J Edwards, MD

  • Family Medicine Physician
  • Walla Walla, WA
National Provider Identifier
1932115169
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00019832 Issued in WA
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

Updated by the provider on Apr 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1932115169MedicaidWA
150600MedicaidOR

Electronic endpoints 2

TypeEndpointUseAffiliation
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

OrganizationSpecialtyStatusNew patients
R & B Fleck Enterprises, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.