Blake Edes

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP-4067 Issued in ID

Practice address

13075 W Persimmon LN Ste 120
Boise, ID 83713-1986

Phone

(208) 793-7006

Fax

(208) 793-7007

NPI assigned

Nov 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Idaho Voice and Swallow Center LLC

  • Speech-Language Pathologist
  • Meridian, ID
  • NPI 1720845316
  Medicare reassignment NPD Authorized official
• Chatterton Speech Therapy, LLC

  • Speech-Language Pathologist
  • Boise, ID
  • NPI 1932501558
  Medicare reassignment NPD
• Chatterbox Pediatric Therapy

  • Speech-Language Pathologist
  • Nampa, ID
  • NPI 1972423556
  NPD (past)

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1184194789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4628 W PASADENA LN APT 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837056527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13075 W PERSIMMON LN STE 120",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131986",
            "telephone_number": "208-793-7006",
            "fax_number": "208-793-7007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 11th Ave S Ste 155",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836513918",
            "country_code": "US",
            "telephone_number": "208-466-1077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7091 W Emerald St",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837048618",
            "country_code": "US",
            "telephone_number": "208-898-1368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDES",
        "first_name": "BLAKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-4067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263162410",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Anthony Eckhoff, PA-C
• Alisha D Ecklar, M.S. CCC-SLP
• Tucker Tyler Eddins
• Christine Lea Eden, MD
• Holly R Eden, M.ED.
• Brandi Edgerton
• Edgewood Castle Hills LLC
• Edgewood Plantation Place LLC
• Edgewood Spring Creek Boise, LLC
• Edgewood Spring Creek Eagle Island LLC

• Speech-Language Pathologist in Boise, ID
• Providers in Boise, ID by specialty
• Speech-Language Pathologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.