NPIMap

Organization Active NPI

Valley Vista Therapy Services

  • Speech-Language Pathologist
  • St Maries, ID
National Provider Identifier
1073718391
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP-1123 Issued in ID
Legal business name
VALLEY VISTA THERAPY SERVICES
Practice address
820 Elm St
St Maries, ID 83861-2119
Phone
(208) 245-4576
Fax
(208) 245-5909
NPI assigned
Jun 18, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Sandy Kennelly
Title
Corporate Compliance Manager
Phone
(208) 245-4576

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT-160 ID
Occupational Medicine Physician 2083X0100X OT-510 ID
Occupational Medicine Physician 2083X0100X OT-061 ID
Speech-Language Pathologist 235Z00000X SLP-1123 ID Primary

Addresses

Primary practice location

820 Elm St
St Maries, ID 83861-2119

Mailing address

820 Elm St
St Maries, ID 83861-2119
Phone (208) 245-4576

National Provider Directory

National Provider Directory
Tax ID family
Valley Vista Care Corporation20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1073718391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 ELM ST",
            "city": "ST MARIES",
            "state": "ID",
            "postal_code": "838612119",
            "telephone_number": "208-245-4576",
            "fax_number": "208-245-5909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 ELM ST",
            "city": "ST MARIES",
            "state": "ID",
            "postal_code": "838612119",
            "telephone_number": "208-245-4576",
            "fax_number": "208-245-5909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY VISTA THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "KENNELLY",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "CORPORATE COMPLIANCE MANAGER",
        "authorized_official_telephone_number": "208-245-4576"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "ID",
            "license": "PT-160",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "ID",
            "license": "OT-510",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "ID",
            "license": "OT-061",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-1123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Maries, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.