Active NPI
Kristine Scanlon
- Speech-Language Pathologist
- Boise, ID
National Provider Identifier
1235553017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP-2413
- Practice address
- 600 N Robbins Rd
Boise, ID 83702-4565 - Phone
- (208) 489-4635
- NPI assigned
- Feb 13, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP-2413 | ID | Primary |
Addresses
Primary practice location
600 N Robbins Rd
Boise, ID 83702-4565
Mailing address
600 N Robbins Rd
Boise, ID 83702
Phone (208) 489-4635
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
| License | State | Type | Specialty |
|---|---|---|---|
| SLP-2413 | ID | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392249600000",
"number": "1235553017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 N ROBBINS RD",
"city": "BOISE",
"state": "ID",
"postal_code": "83702",
"telephone_number": "208-489-4635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N ROBBINS RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837024565",
"telephone_number": "208-489-4635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCANLON",
"first_name": "KRISTINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-02-13",
"last_updated": "2014-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "ID",
"license": "SLP-2413",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.