Rachel Ann Seibold, M.S. CCC-SLP

Key facts

NPI

1104066539

Entity type

Individual (NPI type 1)

Primary specialty

Speech-Language Pathologist 235Z00000X

License

SLP-1928 (ID)

Practice address

1254 Swisher Rd
Pocatello, ID 83204

Phone

(208) 945-9495

NPI assigned

Feb 25, 2009

Sex

Female

Sole proprietor

Yes

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.

• Speech Therapy Services, LLC Speech-Language Pathologist · Pocatello, ID · NPI 1669798971
  NPD (past) SPEECH-LANGUAGE PATHOLOGIST

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Master of Science

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 23, 2010.

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266883200000",
    "number": "1104066539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1254 SWISHER RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83204",
            "telephone_number": "208-945-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1254 SWISHER RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83204",
            "telephone_number": "208-945-9495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIBOLD",
        "first_name": "RACHEL",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-25",
        "last_updated": "2010-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-1928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Pocatello, ID · Speech-Language Pathologist in Idaho