Individual provider Active NPI

Christopher Leif Edwards

  • Family Nurse Practitioner
  • Idaho Falls, ID
National Provider Identifier
1023886397
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
78244 Issued in ID
Practice address
2330 Coronado St
Idaho Falls, ID 83404-7407
Phone
(208) 542-7060
NPI assigned
Dec 18, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 78244 ID Primary

Addresses

Primary practice location

2330 Coronado St
Idaho Falls, ID 83404-7407

Mailing address

810 N 650 E # 8
Basalt, ID 83218-7706
Phone (208) 243-4520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240313001878 ID Practitioner - Nurse Practitioner 9032555057 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CC Pocatello LLCGroup PAC ID 8527353176, 7 clinicians
Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians
Community Care West Side LLCGroup PAC ID 3678738218, 17 clinicians

Practice addresses (Care Compare)

1595 Yellowstone Ave
Pocatello, ID 83201-4203
Phone (208) 233-0032

2330 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-1234

765 S Utah Ave
Idaho Falls, ID 83402-5093
Phone (208) 585-2600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care West Side LLC CurrentSince Jan 1, 2025 Accepting new patients
Community Care Pocatello PLLC Current Accepting new patients
Mountain View Hospital LLC CurrentSince Feb 3, 2024 Accepting new patients
CC Pocatello LLC CurrentSince Jan 1, 2025 Accepting new patients
Community Care Current Accepting new patients
Mountain View Hospital Physician Organization Past Accepting new patients

Locations

765 S Utah Ave
Idaho Falls, ID 83402
Phone (208) 525-2600

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

2330 Coronado St
Idaho Falls, ID 83404
Phone (208) 552-1234

2725 Channing Way
Idaho Falls, ID 83404
Phone (208) 525-8448

2730 Channing Way
Idaho Falls, ID 83404
Phone (208) 542-7100

1595 Yellowstone Ave
Pocatello, ID 83201
Phone (208) 233-0032

404 N 2nd E
Rexburg, ID 83440
Phone (208) 359-1770

167 E 1st S
Rigby, ID 83442
Phone (208) 745-8747

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1023886397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 N 650 E # 8",
            "city": "BASALT",
            "state": "ID",
            "postal_code": "832187706",
            "telephone_number": "208-243-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047407",
            "telephone_number": "208-542-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "CHRISTOPHER",
        "middle_name": "LEIF",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "78244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.