Blake Edwards, PT, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

2021031365 Issued in MO

Practice address

3801 Selsa Rd Ste 7
Independence, MO 64057-1712

Phone

(816) 795-0434

Fax

(816) 795-0482

NPI assigned

Aug 10, 2021

Last updated

Aug 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1164197406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 SELSA RD STE 7",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 SELSA RD STE 7",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571712",
            "telephone_number": "816-795-0434",
            "fax_number": "816-795-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "BLAKE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-10",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "2021031365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chinenyem Echendu
• Rachel N Eckles, MSW, LCSW
• Cindee Eddins, PHARMACIST
• Ami Kavi Edwards, MD
• Anna Edwards
• George A Edwards, MD
• Edwin M. Myers, D.D.S., P.C.
• Sarah Caitlin Eggleston, MD
• Gloria A Egner Jester, LCSW KS LCSW MO
• Marcus Justin Ehrhart

• Physical Medicine & Rehabilitation Physician in Independence, MO
• Providers in Independence, MO by specialty
• Physical Medicine & Rehabilitation Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.