Elizabeth B Renzello, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP-1284 Issued in ID

Practice address

4650 Hawthorne Rd
Chubbuck, ID 83202-2376

Phone

(208) 238-3349

NPI assigned

Sep 14, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1598047755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 KIERSTEN DR",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832027705",
            "telephone_number": "208-705-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 HAWTHORNE RD",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022376",
            "telephone_number": "208-238-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENZELLO",
        "first_name": "ELIZABETH",
        "middle_name": "B",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-14",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-1284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Pugmire
• Jared C Pugmire, PT DPT
• Thomas Putnam, LPC
• Fahim Rahim, M.D.
• Naeem Rahim, M.D.
• Katrina Rhett, PT
• David E Richardson, LPC
• Liva Rigney-Cox
• Diana Rivas, PARAPROFESSIONAL
• Amber Romriell, M.S. CCC- SLP

• Speech-Language Pathologist in Chubbuck, ID
• Providers in Chubbuck, 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 Sep 24, 2012; 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.