Kelcey Ryan Edwards, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN5230434 Issued in FL

Practice address

1700 E Smithville Western Rd
Wooster, OH 44691-1010

Phone

(330) 601-1001

Fax

(330) 345-0001

NPI assigned

Dec 21, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1942079736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8315 STATE ROUTE 179",
            "city": "LAKEVILLE",
            "state": "OH",
            "postal_code": "446389704",
            "telephone_number": "330-988-4283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E SMITHVILLE WESTERN RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446911010",
            "telephone_number": "330-601-1001",
            "fax_number": "330-345-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KELCEY",
        "middle_name": "RYAN",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-21",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5230434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian J Edgell
• Roger Charles Edgington, R. PH.
• Rebecca L Edmondson, QMHS
• Darnell Larry Edwards, CDCA
• Joanna Edwards
• Lillie Edwards
• Patricia E Edwards, LSW
• Brittani Marie Eggan
• Jamie Eggeman, QMHS-B
• Laureen Egyin-Akesseh

• Licensed Practical Nurse in Wooster, OH
• Providers in Wooster, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.