Casey's Specialty Speech, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

CASEY'S SPECIALTY SPEECH, LLC

Practice address

611 Wilson Ave Ste 6C
Pocatello, ID 83201-5046

Phone

(208) 242-7377

Fax

(208) 417-0956

NPI assigned

May 14, 2019

Organization subpart

No

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

Authorized official

Name

Casey Ulrich, M.S., CCC-SLPNPI 1073959441

Title

Owner/Speech Therapist

Phone

(208) 242-7377

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Casey Ulrich, M.S.CCC-SLP

  • Speech-Language Pathologist
  • Chubbuck, ID
  • NPI 1073959441
  Medicare reassignment NPD Authorized official
• Tenille Rudeen, SLP

  • Speech-Language Pathologist
  • Pocatello, ID
  • NPI 1033099585
  NPD

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652745600000",
    "number": "1528624673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13413 N MOONGLOW LN",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832025122",
            "telephone_number": "208-242-7377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 WILSON AVE STE 6C",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015046",
            "telephone_number": "208-242-7377",
            "fax_number": "208-417-0956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13413 N Moonglow Ln",
            "address_purpose": "LOCATION",
            "city": "Pocatello",
            "state": "ID",
            "postal_code": "832025122",
            "country_code": "US",
            "telephone_number": "208-242-7377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CASEY'S SPECIALTY SPEECH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-14",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A",
        "authorized_official_last_name": "ULRICH",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "OWNER/SPEECH THERAPIST",
        "authorized_official_telephone_number": "208-242-7377",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528624673",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Carson, OTR/L
• Ashley Carter
• Linda E Carter, MD
• Jesse Allen Case, LMSW
• Jacob Casebolt, AT
• Angela D. Casperson, PHARM.D.
• Jamie Leigh Cassinat, CRNA
• Jenna Marie Castillo, PA-C
• Mosiah Castrejon, LPC, NCC
• Melissa Ann Caudle, MHE, CWP

• Speech-Language Pathologist in Pocatello, ID
• Providers in Pocatello, 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 May 17, 2022; 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.

Verify at the official NPI Registry.