KENNETH ANTHONY EDWARDS, Ph.D. — NPI 1003939356 (Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Forensic in MOUND HOUSE, NV)

CMS-1500 Box 24J / 33a • NPI

1003939356

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

103TF0200X (CMS 62)

Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Forensic

Box 32 Service Location & ZIP+4

10116 HIGHWAY 50 EAST, SUITE 101, MOUND HOUSE, NV, 89706

Official NPPES Practice Location

Practice Phone & Referral Fax

(775) 841-3116

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1003939356 (KENNETH ANTHONY EDWARDS, Ph.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1003939356` (NPI-1 Individual Practitioner)
Provider / Legal Name	KENNETH ANTHONY EDWARDS, Ph.D.
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Forensic NUCC Code: `103TF0200X` (Psychologist, Forensic)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	10116 HIGHWAY 50 EAST, SUITE 101, MOUND HOUSE, NV, 89706
Practice Telephone / Fax	Tel: (775) 841-3116
Administrative Mailing Address	PO BOX 115, DAYTON, NV, 89403-0115
Enumeration & Last Sync	Enumerated: 2007-04-09 \| CMS Record Updated: 2025-09-11

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

10116 HIGHWAY 50 EAST, SUITE 101, MOUND HOUSE, NV, 89706

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Plain-English Taxonomy & CMS Crosswalk (103TF0200X)

What Does Taxonomy Code 103TF0200X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103TF0200X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Forensic"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 62 (Psychologist, Clinical)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Psychologist, Forensic for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (KENNETH ANTHONY EDWARDS, Ph.D.)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`103T00000X` — Psychologist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist	State: NV \| License: `PY0409` \| Primary: Secondary
`103T00000X` — Psychologist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist	State: WI \| License: `1167` \| Primary: Secondary
`103TA0700X` — Psychologist, Adult Development & Aging Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Adult Development & Aging	State: NV \| License: `PY0409` \| Primary: Secondary
`103TA0700X` — Psychologist, Adult Development & Aging Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Adult Development & Aging	State: WI \| License: `1167` \| Primary: Secondary
`103TB0200X` — Psychologist, Cognitive & Behavioral Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Cognitive & Behavioral	State: NV \| License: `PY0409` \| Primary: Secondary
`103TB0200X` — Psychologist, Cognitive & Behavioral Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Cognitive & Behavioral	State: WI \| License: `1167` \| Primary: Secondary
`103TF0200X` — Psychologist, Forensic Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Forensic	State: NV \| License: `PY0409` \| Primary: Secondary
`103TF0200X` — Psychologist, Forensic Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Forensic	State: WI \| License: `1167` \| Primary: Yes (Primary)

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KENNETH ANTHONY EDWARDS, Ph.D. (NPI #1003939356)