Physician Compare National (NPI:1710234315)

HEALTHCARE PROVIDER: ANGELA EDWARDS D.P.M

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1710234315
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5597062364
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160322000576
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	EDWARDS
	Individual professional last name
Provider First Name	ANGELA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	TEMPLE UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	DEMING CLINIC CORPORATION
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	8325001548
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	4
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	905 S 8TH ST
	Group Practice or individual's line 1 address
City	DEMING
	Group Practice or individual's city
State	NM
	Group Practice or individual's state
Zip Code	880304037
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5755442030
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	321309
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MIMBRES MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y