Kaili Michelle Smalley

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

12222 W Bridger Bay Dr
Star, ID 83669-5081

Phone

(208) 391-2773

NPI assigned

Dec 11, 2020

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Star Speech and Occupational Therapy LLC

  • Speech-Language Pathologist
  • Star, ID
  • NPI 1669917571

  Single Specialty

  NPD

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1104422336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 N ROBINSON BLVD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836878617",
            "telephone_number": "208-249-7597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12222 W BRIDGER BAY DR",
            "city": "STAR",
            "state": "ID",
            "postal_code": "836695081",
            "telephone_number": "208-391-2773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLEY",
        "first_name": "KAILI",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kari-Lyn Ruby, LMT
• Melinda W Sater, PHARM.D.
• Kourtney Schaffner, CCC-SLP
• Clayton Towner Shaw, P.T.
• Alyssa Shirley, OTR/L
• Elizabeth Dockerty Smith, DDS, MSD
• Jennifer Lynn Snow, PTA
• Megan Socha, RDN
• Speech Cloud
• Sherry Lynn Stanton, NP

• Student in an Organized Health Care Education/Training Program in Star, ID
• Providers in Star, ID by specialty
• Student in an Organized Health Care Education/Training Program in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.