NPIMap

Organization Active NPI

Childs Play, LLC

  • Speech-Language Pathologist
  • Victor, ID
National Provider Identifier
1598086126
Registry record updated Jul 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP1143 Issued in ID
Legal business name
CHILDS PLAY, LLC
Practice address
73 North Main
Victor, ID 83455
Phone
(208) 787-6900
NPI assigned
Jun 17, 2010
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mrs. Kimberly Richardson Gutierrez, M.A., CCC/SLP
Title
Speech-Language Pathologist
Phone
(307) 413-1829

Practitioners 3

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

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SLP1143 ID Primary

Addresses

NPPES NPI Registry

Primary practice location

73 North Main
Victor, ID 83455

Mailing address

PSC 485 Box 351
Fpo, AP 96321-0004

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 10, 2012.

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341878400000",
    "number": "1598086126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "PSC 485 BOX 351",
            "city": "FPO",
            "state": "AP",
            "postal_code": "963210004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 NORTH MAIN",
            "city": "VICTOR",
            "state": "ID",
            "postal_code": "83455",
            "telephone_number": "208-787-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDS PLAY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-17",
        "last_updated": "2012-07-10",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "RICHARDSON",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "307-413-1829",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.A., CCC/SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP1143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victor, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.