NPIMap

Organization Active NPI

Idaho State University - Meridian

  • Speech-Language Pathologist
  • Meridian, ID
National Provider Identifier
1083860415
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
IDAHO STATE UNIVERSITY - MERIDIAN
Practice address
1311 E Central Dr
Meridian, ID 83642-7991
Phone
(208) 373-1728
Fax
(208) 373-1811
NPI assigned
Aug 18, 2008
Last updated
Jun 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Authorized official

Name
Ms. Jeanne M Johnson, PHD, CCC SLP
Title
Associate Chair
Phone
(208) 373-1728

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X ID Primary

Addresses

Primary practice location

1311 E Central Dr
Meridian, ID 83642-7991

Mailing address

1311 E Central Dr
Meridian, ID 83642-7991
Phone (208) 373-1728

National Provider Directory

National Provider Directory
Tax ID family
Idaho State University22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276560000000",
    "number": "1083860415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 E CENTRAL DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427991",
            "telephone_number": "208-373-1728",
            "fax_number": "208-373-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 E CENTRAL DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427991",
            "telephone_number": "208-373-1728",
            "fax_number": "208-373-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO STATE UNIVERSITY - MERIDIAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-18",
        "last_updated": "2010-06-15",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ASSOCIATE CHAIR",
        "authorized_official_telephone_number": "208-373-1728",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHD, CCC SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; 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.