Individual provider Active NPI

Misty Edge, CRPS

  • Peer Specialist
  • Fountain, FL
National Provider Identifier
1619824976
Registry record updated Mar 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
CRPS.0101304.A Issued in FL
Practice address
11911 Jasmine St
Fountain, FL 32438-2727
Phone
(850) 451-7294
NPI assigned
Mar 14, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X CRPS.0101304.A FL Primary

Addresses

Primary practice location

11911 Jasmine St
Fountain, FL 32438-2727

Mailing address

11911 Jasmine St
Fountain, FL 32438-2727
Phone (850) 451-7294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CRPS.0101304.AFLMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1773446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773446400000",
    "number": "1619824976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11911 JASMINE ST",
            "city": "FOUNTAIN",
            "state": "FL",
            "postal_code": "324382727",
            "telephone_number": "850-451-7294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11911 JASMINE ST",
            "city": "FOUNTAIN",
            "state": "FL",
            "postal_code": "324382727",
            "telephone_number": "850-451-7294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGE",
        "first_name": "MISTY",
        "name_prefix": "Mrs.",
        "credential": "CRPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-14",
        "last_updated": "2026-03-14",
        "certification_date": "2026-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "FL",
            "license": "CRPS.0101304.A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2026; 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.