Active NPI
Tammy Emerson, MS CCC SLP
- Speech-Language Pathologist
- Jerome, ID
National Provider Identifier
1306003306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP1266
- Practice address
- 405 E Avenue a
Jerome, ID 83338-2704 - Phone
- (208) 308-5808
- Fax
- (208) 324-3440
- NPI assigned
- May 19, 2008
- 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 | SLP1266 | ID | Primary |
Addresses
Primary practice location
405 E Avenue a
Jerome, ID 83338-2704
Mailing address
405 E Avenue a
Jerome, ID 83338-2704
Phone (208) 308-5808
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120411000820 | ID | Practitioner - Qualified Speech Language Pathologist | 3779744180 | Practice locations: Twin Falls, ID |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP1266 | ID | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211155200000",
"number": "1306003306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 E AVENUE A",
"city": "JEROME",
"state": "ID",
"postal_code": "833382704",
"telephone_number": "208-308-5808",
"fax_number": "208-324-3440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 E AVENUE A",
"city": "JEROME",
"state": "ID",
"postal_code": "833382704",
"telephone_number": "208-308-5808",
"fax_number": "208-324-3440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMERSON",
"first_name": "TAMMY",
"credential": "MS CCC SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-19",
"last_updated": "2008-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "ID",
"license": "SLP1266",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jerome, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.