Individual provider Active NPI

Suzanne May Neidermyer, M.A.

  • Speech-Language Pathologist
  • Boise, ID
National Provider Identifier
1043643893
Registry record updated Aug 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP2427 Issued in ID
Practice address
901 N Curtis Rd Ste 204
Boise, ID 83706-1340
Phone
(208) 367-3315
NPI assigned
Aug 15, 2013
Last updated
Aug 15, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2013

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 SLP2427 ID Primary

Addresses

Primary practice location

901 N Curtis Rd Ste 204
Boise, ID 83706-1340

Mailing address

3536 S Selatir PL
Meridian, ID 83642-7047
Phone (858) 922-0415

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 Arts

State licenses

LicenseStateTypeSpecialty
SLP2427IDMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1043643893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 S SELATIR PL",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427047",
            "telephone_number": "858-922-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N CURTIS RD STE 204",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061340",
            "telephone_number": "208-367-3315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIDERMYER",
        "first_name": "SUZANNE",
        "middle_name": "MAY",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-15",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP2427",
            "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 Aug 15, 2013; 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.