MS. PETRA EDWARDS (NPI# 1154791259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154791259 |
| Entity Type | Individual |
| Full Name | MS. PETRA EDWARDS |
| Credential | FNP |
| Practice Address |
1228 Harden St Ste.c Columbia SC 29204-1800 |
| Mailing Address |
Po Box 3788 Columbia SC 29230-3788 |
| Practice Telephone | 8037481181 |
| Practice Fax Number | 8037481185 |
| Mailing Telephone | 8037335969 |
| Mailing Fax Number | 8037535591 |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2016-10-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
19767 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NP3459 | 05 |
| Street Address |
1228 HARDEN ST STE.C |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29204-1800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346249430 | Eau Claire Cooperative Health Center, Inc. | Family Medicine | 1228 Harden St, Columbia, SC 29204-1800 | 2005-07-20 |
| 1114468832 | Shanda Hill | Nurse Practitioner | 1228 Harden St, Ste. B, Columbia, SC 29204-1800 | 2017-03-14 |
| 1013369453 | Allison Stoughton Moore | Nurse Practitioner | 1228 Harden St, Columbia, SC 29204-1800 | 2016-07-11 |
| 1851762694 | Allison Murrell | Nurse Practitioner | 1228 Harden St, Ste.c, Columbia, SC 29204-1800 | 2015-10-19 |
| 1063829547 | Carolina Ob/gyn Group, LLC | Obstetrics & Gynecology | 1228 Harden St, Columbia, SC 29204-1800 | 2014-07-17 |
| 1588093728 | Rosa Maria Castillo Schilder | Obstetrics & Gynecology | 1228 Harden St, Columbia, SC 29204-1800 | 2013-11-07 |
| 1417385899 | Five Points Cooperative Pharmacy | Pharmacy | 1228 Harden St, Columbia, SC 29204-1800 | 2013-10-23 |
| 1306185509 | Eau Claire Cooperative Health Center Inc. | Clinic/Center | 1228 Harden St, Ste.b, Columbia, SC 29204-1800 | 2013-02-07 |
| 1144502444 | Tabitha Garner | Nurse Practitioner | 1228 Harden St, Columbia, SC 29204-1800 | 2011-09-13 |
| 1740577469 | Tessa Vera Gonzalez | Pediatrics | 1228 Harden St, Columbia, SC 29204-1800 | 2011-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992215149 | Ricardo Colon II | Registered Nurse | 3000 Hampton Street, Columbia, SC 29204 | 2017-10-02 |
| 1780113522 | Carla Star Noe | Registered Nurse | Sc Department of Health and Environmental Control, 2100 Bull Street, Collumbia, SC 29204 | 2017-06-06 |
| 1124568514 | Kristy L Thompson | Nurse Practitioner | 1655 Bernardin Ave Ste 240, Columbia, SC 29204 | 2017-03-03 |
| 1982052031 | Harold Eugene Cook Iv | Podiatrist | 1730 St Julian Place, Columbia, SC 29204 | 2016-05-31 |
| 1851748974 | Shaquita Banks | Counselor | 1810 Allen Benedict Ct, A1, Columbia, SC 29204 | 2016-05-18 |
| 1265804835 | Premier Care, LLC | Case Management | 2712 Middleburg Drive, Suite 206, Columbia, SC 29204 | 2015-10-22 |
| 1023492287 | Shamiquia N. Mcpherson | Counselor | 1627 Auburn St., Columbia, SC 29204 | 2015-07-16 |
| 1285028449 | The Columbia Free Medical Clinic, Inc. | Clinic/Center | 1875 Harden Street, Columbia, SC 29204 | 2015-03-26 |
| 1629473459 | Leslie Wilson | Counselor | 2323 Lady Street, Columbia, SC 29204 | 2014-10-22 |
| 1053728683 | Candyce Sutton | Social Worker | 1135 Carter Street, Columbia, SC 29204 | 2014-07-15 |
| Find all providers in zip 29204 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114526266 | Leslie Desha | Nurse Practitioner | 1109 Pheasant Run, Columbia, MO 65201-6253 | 2020-10-20 |
| 1407454101 | Jason D Jones | Nurse Practitioner | 213 Austell Dr, Columbia, TN 38401-5531 | 2020-10-14 |
| 1316544315 | Rezvaneh Goodarzi | Nurse Practitioner | 8830 Tamar Dr Apt 301, Columbia, MD 21045-2962 | 2020-10-03 |
| 1316559255 | Lauren Olivia Lenauer | Nurse Practitioner | 1600 E Broadway # 300, Columbia, MO 65201-5844 | 2020-08-21 |
| 1285246272 | Lourdes Claire De Las Alas | Nurse Practitioner | 6005 Shepherd Sq, Columbia, MD 21044-3114 | 2020-08-20 |
| 1619587540 | Josey Abraham | Nurse Practitioner | 305 Aiken Hunt Cir, Columbia, SC 29223-8407 | 2020-08-05 |
| 1588274765 | Tomeka Nichole Jackson | Nurse Practitioner | 6156 Saint Andrews Rd Ste 208, Columbia, SC 29212-3147 | 2020-08-03 |
| 1528696762 | Mark Edward Merkel | Nurse Practitioner | 1040 N James M Campbell Blvd, Columbia, TN 38401-2756 | 2020-04-01 |
| 1306489265 | Andrew Leitch | Nurse Practitioner | 313 N Trenholm Rd, Columbia, SC 29206-3207 | 2019-10-23 |
| 1760033476 | Emily Smith | Nurse Practitioner | 157 Chinquapin Cir, Columbia, SC 29212-2902 | 2019-09-24 |
| Find all providers in COLUMBIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.