Individual provider Active NPI

Chelsie Fortune, SLP

  • Speech-Language Pathologist
  • Rexburg, ID
National Provider Identifier
1003791070
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP-5845 Issued in ID
Practice address
36 Professional PLZ Ste 110
Rexburg, ID 83440-2049
Phone
(208) 359-9570
Fax
(208) 359-9580
NPI assigned
Aug 8, 2025
Last updated
Aug 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP-5845 ID Primary

Addresses

Primary practice location

36 Professional PLZ Ste 110
Rexburg, ID 83440-2049

Mailing address

36 Professional PLZ Ste 110
Rexburg, ID 83440-2049
Phone (208) 359-9570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251007003359 ID Practitioner - Qualified Speech Language Pathologist 3274030234 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

36 Professional PLZ
Suite 110
Rexburg, ID 83440-2047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SLP-5845IDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
MHD Therapies, PLLC Speech-Language Pathologist CurrentSince Sep 1, 2025 Accepting new patients

Locations

36 Professional Plz
Ste 110
Rexburg, ID 83440
Phone (208) 359-9570

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1754611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1003791070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 PROFESSIONAL PLZ STE 110",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402049",
            "telephone_number": "208-359-9570",
            "fax_number": "208-359-9580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 PROFESSIONAL PLZ STE 110",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402049",
            "telephone_number": "208-359-9570",
            "fax_number": "208-359-9580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTUNE",
        "first_name": "CHELSIE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-08",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-5845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rexburg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; 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.