NPIMap

Individual provider Active NPI

Kirsten T Lewis, MS,CCC-SLP

  • Speech-Language Pathologist
  • Caldwell, ID
National Provider Identifier
1407201312
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP-2094 Issued in ID
Practice address
1906 Fairview Ave
Suite 330
Caldwell, ID 83605-5407
Phone
(208) 454-9223
NPI assigned
Apr 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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-2094 ID Primary

Addresses

Primary practice location

1906 Fairview Ave
Suite 330
Caldwell, ID 83605-5407

Mailing address

1906 Fairview Ave
Suite 330
Caldwell, ID 83605-5407
Phone (208) 454-9223

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SLP-2094IDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Reach the Summit Language and Literacy Clinic, LLC Speech-Language Pathologist Current Accepting new patients
St Lukes Clinic-Treasure Valley LLC Past Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1407201312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 FAIRVIEW AVE",
            "address_2": "SUITE 330",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836055407",
            "telephone_number": "208-454-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 FAIRVIEW AVE",
            "address_2": "SUITE 330",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836055407",
            "telephone_number": "208-454-9223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KIRSTEN",
        "middle_name": "T",
        "credential": "MS,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-28",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-2094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; 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.