Alexandra Deon

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP-4786 Issued in ID

Practice address

207 W Georgia Ave Ste 170
Nampa, ID 83686-3024

Phone

(208) 467-1069

NPI assigned

Jun 9, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rise Early Intervention Services LLC

  • Early Intervention Provider Agency
  • Mesa, AZ
  • NPI 1669818035

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1518534320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 W GEORGIA AVE STE 170",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836863024",
            "telephone_number": "208-467-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 W GEORGIA AVE STE 170",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836863024",
            "telephone_number": "208-467-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEON",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-4786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "SLP-4786",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SLP-4786",
            "identifier": "SLP-4786",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Imaginepediatric.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "207 W Georgia Ave Ste 170",
            "city": "Nampa",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836863024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cheri Dent, LCPC
• Dental Care West, LLC
• Dental Partners, PLLC
• Dentists of Nampa, PC
• Dentures by Design of Idaho, Inc.
• Thomas Dwight Deppe, DDS
• Dermatology Center of Canyon County
• Calvin Despain, DDS
• Development Enterprises, Inc.
• Karyn Devereux, DPT

• Speech-Language Pathologist in Nampa, ID
• Providers in Nampa, ID by specialty
• Speech-Language Pathologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.