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BLAKE SCOTT EDMONSON MD
NPI 1669115242
Student in an Organized Health Care Education/Training Program in Memphis, TN

Active since April 20, 2022PECOS Enrolled
920 MADISON AVENUE SUITE 447, MEMPHIS, TN 38163(615) 396-6454 Get Directions Write a Review

NPPES record last updated: March 25, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Blake Scott Edmonson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLAKE SCOTT EDMONSON MD (NPI 1669115242) is an individual student in an organized health care education/training program in Memphis, Tennessee and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669115242
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameBLAKE SCOTT EDMONSONCredential: MD
Location Address920 MADISON AVENUE SUITE 447Memphis, TN 38163-1702
Mailing Address1020 N Highland Ave Ste CMurfreesboro, TN 37130-2494
Phone(615) 396-6454
Sole ProprietorNo
Enumeration DateApril 20, 2022
Last NPPES UpdateMarch 25, 2024
NPPES CertifiedMarch 25, 2024
✔ NPI 1669115242 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

920 MADISON AVENUE SUITE 447, Memphis, TN 38163
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Blake Scott Edmonson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LOUIS SAMUEL REIER D.O.
Student in an Organized Health Care Education/Training Program
920 MADISON AVENUE SUITE 447
MEMPHIS, TN 38163
Shelby County (731) 927-8442
BUSRA GUNGOR MD
Student in an Organized Health Care Education/Training Program
920 MADISON AVENUE SUITE 447
MEMPHIS, TN 38163
Shelby County (901) 448-4795
ROBERT BENJAMIN SMITH MD
Student in an Organized Health Care Education/Training Program
920 MADISON AVENUE SUITE 447
MEMPHIS, TN 38163
Shelby County (901) 448-0230
KAREN SOPHIA PARK MD
Student in an Organized Health Care Education/Training Program
920 MADISON AVENUE SUITE 447
MEMPHIS, TN 38163
Shelby County (901) 448-5814
STEFAN HANISH
Student in an Organized Health Care Education/Training Program
920 MADISON AVENUE SUITE 447
MEMPHIS, TN 38163
Shelby County (901) 759-3275
MATTHEW DAVID SMITH MD
Student in an Organized Health Care Education/Training Program
920 MADISON AVENUE SUITE 447
MEMPHIS, TN 38163
Shelby County (901) 759-3275
CHRISTOPHER MCCLURE
Internal Medicine
920 MADISON AVENUE SUITE 447
MEMPHIS, TN 38163
Shelby County (901) 448-5364
JOSEPH ROBERT JOHNSON
Student in an Organized Health Care Education/Training Program
920 MADISON AVENUE SUITE 447
MEMPHIS, TN 38163
Shelby County (901) 759-3275

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blake Edmonson's NPI number?

The NPI number for Blake Edmonson is 1669115242. It was assigned to this individual provider in the NPPES registry on April 20, 2022.

Where is Blake Edmonson located?

Blake Edmonson practices at 920 Madison Avenue Suite 447, Memphis, TN 38163. The listed phone number is (615) 396-6454.

What is Blake Edmonson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Blake Edmonson enrolled in Medicare?

Yes. Blake Edmonson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Blake Edmonson was last updated on March 25, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.