Individual provider Active NPI

Jenna Edwards, NP-C

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1972960136
Registry record updated Apr 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
TAP8396 Issued in AZ
Practice address
5170 E Glenn St
Building 2 Suite 160
Tucson, AZ 85712-1396
Phone
(520) 298-7900
NPI assigned
Jan 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2017

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 TAP8396 AZ Primary

Addresses

Primary practice location

5170 E Glenn St
Building 2 Suite 160
Tucson, AZ 85712-1396

Mailing address

5170 E Glenn St
Building 2 Suite 160
Tucson, AZ 85712-1396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20160222001696 AZ Practitioner - Nurse Practitioner 5890090310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Marshall Cardiology, PCGroup PAC ID 7911940507, 4 clinicians

Practice addresses (Care Compare)

5170 E Glenn St BLDG 2
Suite 160
Tucson, AZ 85712-7302
Phone (520) 298-7900

Hospital & facility affiliations

  • Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TAP8396AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall Cardiology, PC CurrentSince Feb 1, 2016 Accepting new patients

Locations

5170 E Glenn St
Bldg 2
Tucson, AZ 85712
Phone (520) 298-7900

5170 E Glenn St
Ste 160
Tucson, AZ 85712
Phone (520) 298-7900

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491782400000",
    "number": "1972960136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5170 E GLENN ST",
            "address_2": "BUILDING 2 SUITE 160",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857121396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5170 E GLENN ST",
            "address_2": "BUILDING 2 SUITE 160",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857121396",
            "telephone_number": "520-298-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JENNA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-19",
        "last_updated": "2017-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "TAP8396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.