Active NPI
Amy S Edwards, MD
- Psychiatry Physician
- Boise, ID
National Provider Identifier
1881688810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- M-11410
- Practice address
- 2550 W Targee St Apt 102
Boise, ID 83705-4494 - Phone
- (818) 731-2100
- NPI assigned
- Sep 6, 2005
- Last updated
- May 27, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | M-11410 | ID | Primary |
Addresses
Primary practice location
2550 W Targee St Apt 102
Boise, ID 83705-4494
Mailing address
20054 Crestview Dr
Canyon Country, CA 91351-5756
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120106000234 | ID | Practitioner - Psychiatry | 7012941826 | Practice locations: Eagle, ID |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-11410 | ID | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779840000000",
"number": "1881688810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20054 CRESTVIEW DR",
"city": "CANYON COUNTRY",
"state": "CA",
"postal_code": "913515756",
"fax_number": "208-345-1890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2550 W TARGEE ST APT 102",
"city": "BOISE",
"state": "ID",
"postal_code": "837054494",
"telephone_number": "818-731-2100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "AMY",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-09-06",
"last_updated": "2026-05-27",
"certification_date": "2026-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "ID",
"license": "M-11410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.