JACOB EDWARDS (NPI# 1730323254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730323254 |
| Entity Type | Individual |
| Full Name | JACOB EDWARDS |
| Credential | MD |
| Practice Address |
5565 Montgomery Hwy Dothan AL 36303-1552 |
| Mailing Address |
126 Clinic Dr Dothan AL 36303-1980 |
| Practice Telephone | 3346993733 |
| Practice Fax Number | 3345003007 |
| Mailing Telephone | 3347931881 |
| Mailing Fax Number | 3343405918 |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2020-05-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | MD.31940 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003190111D | 05 | |
| AL | BCBS | 51222367 | 01 |
| FL | 021006600 | 05 | |
| AL | 141478 | 05 | |
| AL | 229200 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043828163 | Jacob Edwards | Pharmacist | 921 W Main St, Lyons, KS 67554-1708 | 2020-07-15 |
| 1124547427 | Jacob Edwards | Behavioral Analyst | 5501 Antique Rose Way, Riverbank, CA 95367-9505 | 2017-09-18 |
| 1619346848 | Jacob Edwards | Physical Therapist | 3317 N Wimberly Dr, Fayetteville, AR 72703-4056 | 2015-09-17 |
| 1083093678 | Jacob Edwards | Chiropractor | 6401 N Interstate Dr, Suite 148, Norman, OK 73069-9515 | 2015-05-28 |
| 1154700227 | Jacob Daniel Edwards | Student in an Organized Health Care Education/Training Program | 2100 Stantonsburg Rd, Greenville, NC 27834-2818 | 2015-05-22 |
| 1851694046 | Jacob Edwards | Behavioral Analyst | 6759 W Charleston Blvd, Suite 130, Las Vegas, NV 89146-2002 | 2010-12-10 |
| Street Address |
5565 MONTGOMERY HWY |
| City | DOTHAN |
| State | AL |
| Zip Code | 36303-1552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518915305 | David J Lozano | Pediatrics | 5565 Montgomery Hwy, Dothan, AL 36303-1552 | 2006-05-04 |
| 1750729737 | Heather Mckenzie Choat | Pediatrics | 5565 Montgomery Hwy, Dothan, AL 36303-1552 | 2013-06-12 |
| 1467774646 | Jennifer Muraski | Nurse Practitioner | 5565 Montgomery Hwy, Dothan, AL 36303-1552 | 2010-02-16 |
| 1134269848 | Meredith Cheryl Hitch | Pediatrics | 5565 Montgomery Hwy, Dothan, AL 36303-1552 | 2007-02-08 |
| 1104913235 | Deron Sharpe | Psychiatry & Neurology | 5565 Montgomery Hwy, Dothan, AL 36303-1552 | 2006-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194205740 | Emblom & Vaughn, D.m.d., PC | Dentist | 318 Healthwest Dr., Dothan, AL 36303 | 2018-08-14 |
| 1164887907 | Bio-medical Applications of Alabama, Inc. | Clinic/Center | 118 Obrannan Park Drive, Dothan, AL 36303 | 2015-12-21 |
| 1245634245 | Api Counseling, LLC | Community/Behavioral Health | 1583 Montgomery Highway, Dothan, AL 36303 | 2014-10-20 |
| 1467792382 | Bolanle Boladale Akinduro | Home Health | 107 Hidden Glen Way, Dothan, AL 36303 | 2013-03-01 |
| 1104162114 | Al Dental PC | Dentist | 3400 Montgomery Highway, Dothan, AL 36303 | 2012-12-19 |
| 1659661874 | Juanita Titrud Heersink | Internal Medicine | 210 Westside Drive, Dothan, AL 36303 | 2011-04-08 |
| 1790918548 | Brandi Bradshaw Reeves | Counselor | 100 Westside Dr., Dothan, AK 36303 | 2009-08-27 |
| 1396917589 | Brian Davis | Physical Therapist | 3763 Ross Clark Circle, Dothan, AL 36303 | 2008-03-27 |
| 1558544544 | Healthwest Dental Associates PC | Dentist | 502 Healthwest Drive, Dothan, AL 36303 | 2007-12-12 |
| 1770644775 | Christine Carroll Fain | Occupational Therapist | 3763 Ross Clark Cir Ste 1, Alacare Home Health, Dothan, AL 36303 | 2006-12-13 |
| Find all providers in zip 36303 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518915305 | David J Lozano | Pediatrics | 5565 Montgomery Hwy, Dothan, AL 36303-1552 | 2006-05-04 |
| 1790775807 | Aubrey Lee Scott | Pediatrics | 126 Clinic Dr, Dothan, AL 36303-1980 | 2005-10-28 |
| 1518966522 | April G Beltran | Pediatrics | 418 N Foster St, Dothan, AL 36303-4545 | 2005-07-20 |
| 1447257647 | Angela S Blaxton | Pediatrics | 364 Honeysuckle Rd, Dothan, AL 36305-1140 | 2005-07-01 |
| 1134663487 | Sheridan Rop Services of Alabama, Inc. | Pediatrics | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2016-12-06 |
| 1053731216 | Kristine Campbell Sawyer | Pediatrics | 126 Clinic Dr, Dothan, AL 36303-1980 | 2014-04-25 |
| 1750729737 | Heather Mckenzie Choat | Pediatrics | 5565 Montgomery Hwy, Dothan, AL 36303-1552 | 2013-06-12 |
| 1841557204 | Allison Elizabeth Walker | Pediatrics | 126 Clinic Dr, Dothan, AL 36303-1980 | 2012-04-23 |
| 1407174626 | Cassandra Stein Nosser | Pediatrics | 126 Clinic Dr, Dothan, AL 36303-1980 | 2010-05-12 |
| 1538320825 | Alison Virginia Winstead | Pediatrics | 126 Clinic Dr, Dothan, AL 36303-1980 | 2008-06-19 |
| Find all providers in DOTHAN | ||||
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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.