Active NPI
Patricia Joyce Wolfley, M.S., CCC-SLP
- Speech-Language Pathologist
- Blackfoot, ID
National Provider Identifier
1033562293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 01077360
- Practice address
- 103 S 900 W
Blackfoot, ID 83221-6065 - Phone
- (208) 684-3001
- NPI assigned
- Jul 22, 2016
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 01077360 | ID | Primary |
Addresses
Primary practice location
103 S 900 W
Blackfoot, ID 83221-6065
Mailing address
1120 W Taber Rd
Blackfoot, ID 83221-5111
Phone (208) 680-3036
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01077360 | ID | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Snake River School District 52 | Speech-Language Pathologist | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469145600000",
"number": "1033562293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 W TABER RD",
"city": "BLACKFOOT",
"state": "ID",
"postal_code": "832215111",
"telephone_number": "208-680-3036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 S 900 W",
"city": "BLACKFOOT",
"state": "ID",
"postal_code": "832216065",
"telephone_number": "208-684-3001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLFLEY",
"first_name": "PATRICIA",
"middle_name": "JOYCE",
"name_prefix": "Mrs.",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-22",
"last_updated": "2016-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "ID",
"license": "01077360",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blackfoot, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.