Individual provider Active NPI

Autumn Coombs

  • Speech-Language Pathologist
  • Twin Falls, ID
National Provider Identifier
1104229467
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP-2582 Issued in ID
Practice address
254 River Vista PL
Twin Falls, ID 83301-3006
Phone
(208) 734-7333
Fax
(208) 734-8350
NPI assigned
Oct 1, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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 SLP-2582 ID Primary

Addresses

Primary practice location

254 River Vista PL
Twin Falls, ID 83301-3006

Mailing address

1297 Park Meadows Dr
Twin Falls, ID 83301-3221
Phone (208) 734-7333

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

State licenses

LicenseStateTypeSpecialty
SLP-2582IDMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1104229467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1297 PARK MEADOWS DR",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013221",
            "telephone_number": "208-734-7333",
            "fax_number": "208-734-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 RIVER VISTA PL",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013006",
            "telephone_number": "208-734-7333",
            "fax_number": "208-734-8350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOMBS",
        "first_name": "AUTUMN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-2582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; 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.