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ETHELDRA RENEE EDWARDS
NPI 1942777875
Nurse Practitioner in Tampa, FL

Active since October 29, 2018PECOS EnrolledAccepts Medicare Assignment
16615 VALLELY DR, TAMPA, FL 33618(314) 494-3469 Get Directions Write a Review

NPPES record last updated: February 14, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 14, 2020, Oct 29, 2018 (2 updates tracked since 2018).

About Etheldra Renee Edwards NPPES

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

ETHELDRA RENEE EDWARDS (NPI 1942777875) is an individual nurse practitioner in Tampa, Florida, licensed in Florida (9388632) and active in the NPI registry since October 2018. She is enrolled in Medicare PECOS, maintains a secondary practice location in Temple Terrace, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1942777875
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameETHELDRA RENEE EDWARDS
Location Address16615 VALLELY DRTampa, FL 33618-1132
Mailing Address16615 Vallely DrTampa, FL 33618-1132 · (314) 494-3469
Phone(314) 494-3469
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateOctober 29, 2018
Last NPPES UpdateFebruary 14, 20202 updates tracked since enumeration
✔ NPI 1942777875 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in FL · 9388632
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
16615 VALLELY DR, Tampa, FL 33618
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Secondary Practice Location 1

Location 112470 Telecom Dr Ste 300WTemple Terrace, FL 33637-0904 · Phone (813) 871-8183

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

Etheldra Renee Edwards 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 ID547508178
PECOS Enrollment IDI20240328000216
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33618 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

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 Etheldra Edwards's NPI number?

The NPI number for Etheldra Edwards is 1942777875. It was assigned to this individual provider in the NPPES registry on October 29, 2018.

Where is Etheldra Edwards located?

Etheldra Edwards practices at 16615 Vallely Dr, Tampa, FL 33618. The listed phone number is (314) 494-3469.

What is Etheldra Edwards's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Etheldra Edwards enrolled in Medicare?

Yes. Etheldra 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.

When was this NPI record last updated?

The NPPES record for Etheldra Edwards was last updated on February 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.