Kylie Michelle Bull, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

TSLP-3247 Issued in ID

Practice address

1409 W Main St Ste 120
Boise, ID 83702-5215

Phone

(208) 370-5857

Fax

(208) 506-6312

NPI assigned

Jul 24, 2017

Last updated

May 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Boise Speech Tree, LLC

  • Speech-Language Pathologist
  • Boise, ID
  • NPI 1689168445
  Medicare reassignment NPD
• Speech Tree Inc

  • Speech-Language Pathologist
  • Eagle, ID
  • NPI 1316087323
  NPD

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1063935815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 E WINDING CREEK DR STE 120",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836167242",
            "telephone_number": "208-938-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 W MAIN ST STE 120",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025215",
            "telephone_number": "208-370-5857",
            "fax_number": "208-506-6312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "935 E Winding Creek Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Eagle",
            "state": "ID",
            "postal_code": "836167242",
            "country_code": "US",
            "telephone_number": "208-938-4748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "964 W Idaho Ave",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "OR",
            "postal_code": "979142111",
            "country_code": "US",
            "telephone_number": "208-938-4748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULL",
        "first_name": "KYLIE",
        "middle_name": "MICHELLE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-24",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "TSLP-3247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Hang Bui
• William D Buick, MD
• Jennifer C Buker, RD
• Holly Bukky
• Kassie Bull, MD
• Emily Jean Bullard, LCSW
• Jody Alison Thatcher Bullard, P.T.
• Maree Bullers, NNP
• Marlayna Bullington
• Jamie Bumgardner, PMHNP-BC

• Speech-Language Pathologist in Boise, ID
• Providers in Boise, ID by specialty
• Speech-Language Pathologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.