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MRS. THERESA KAY EDWARDS APRN-CNP
NPI 1013494558
Nurse Practitioner - Gerontology in Sidney, OH

Active since July 27, 2018PECOS EnrolledAccepts Medicare Assignment
84.78/100
CMS Quality Rating
1205 FAIRINGTON DR, SIDNEY, OH 45365(937) 492-8431(937) 498-5126 Get Directions Write a Review

NPPES record last updated: December 1, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 1, 2020, Mar 1, 2019, Aug 7, 2018 and 1 more (4 updates tracked since 2018).

About Mrs. Theresa Kay Edwards Aprn-cnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. THERESA KAY EDWARDS APRN-CNP (NPI 1013494558) is an individual gerontology provider in Sidney, Ohio, licensed in Ohio (APRN.CNP.022941) and active in the NPI registry since July 2018. She is enrolled in Medicare PECOS, is affiliated with Wilson Memorial Hospital, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1013494558
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameMRS. THERESA KAY EDWARDSCredential: APRN-CNP
Location Address1205 FAIRINGTON DRSidney, OH 45365-8144
Mailing Address1205 Fairington DrSidney, OH 45365-8144 · (937) 492-8431 · Fax (937) 498-5126
Phone(937) 492-8431
Fax(937) 498-5126
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateJuly 27, 2018
Last NPPES UpdateDecember 1, 20204 updates tracked since enumeration
NPPES CertifiedDecember 1, 2020
✔ NPI 1013494558 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in OH · APRN.CNP.022941
Also ListedRegistered Nurse · General PracticeTaxonomy 163WG0000X · License RN301671 (OH)
1205 FAIRINGTON DR, Sidney, OH 45365
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Theresa Kay Edwards Aprn-cnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1557612504
PECOS Enrollment IDI20181001003119
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
331 services178 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
104 services85 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
54 services40 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
26 services19 patients
Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
21 services19 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
15 services14 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Wilson Memorial Hospital

Acute Care Hospitals · Sidney, OH
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360013
Location915 West Michigan StreetSidney, OH 45365 · Shelby County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45365 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality75.09
Promoting Interoperability100
Improvement Activities40
Cost74.18

Reported Quality Measures

Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
6%531 patients1/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
57%531 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
0%531 patients1/55-star benchmark: 89%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
5 suppliers27 claims38 services$5.09 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
4 suppliers14 claims14 services$0.98 avg. paid by Medicare
Enteral nutrition infusion pump, any type B9002
Other-Enteral and Parenteral · category OB005N
1 supplier12 claims12 services$81.81 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEPHEN JUSTICE MD
Family Medicine
1205 FAIRINGTON DR
SIDNEY, OH 45365
Shelby County (937) 492-8431
ERIC DAVID VANFOSSEN PA-C
Physician Assistant (Medical)
1205 FAIRINGTON DR
SIDNEY, OH 45365
Shelby County (937) 492-8431
PRIMECARE PHYSICIANS OF WEST CENTRAL OHIO, INC
General Practice
1205 FAIRINGTON DR
SIDNEY, OH 45365
Shelby County (937) 492-8431
KENNETH BOSSLET D.O.
Family Medicine
1205 FAIRINGTON DR
SIDNEY, OH 45365
Shelby County (937) 492-8431

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theresa Edwards's NPI number?

The NPI number for Theresa Edwards is 1013494558. It was assigned to this individual provider in the NPPES registry on July 27, 2018.

Where is Theresa Edwards located?

Theresa Edwards practices at 1205 Fairington Dr, Sidney, OH 45365. The listed phone number is (937) 492-8431.

What is Theresa Edwards's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Theresa Edwards enrolled in Medicare?

Yes. Theresa Edwards is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Theresa Edwards accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Anthem Blue Cross and Blue Shield list Theresa Edwards as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Theresa Edwards affiliated with any hospitals?

According to CMS data, Theresa Edwards is affiliated with Wilson Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Theresa Edwards was last updated on December 1, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.