Blooming Minds, Inc

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP-2231 Issued in ID

Legal business name

BLOOMING MINDS, INC

Practice address

1034 N 3Rd St
Suite 5B
Coeur D Alene, ID 83814-3145

Phone

(208) 713-3463

NPI assigned

May 2, 2015

Organization subpart

No

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

Authorized official

Name

Cristina C Stiles, SLP, MS, CCC-SLP

Title

Speech-Language Pathologist

Phone

(208) 713-3463

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1430524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444953600000",
    "number": "1609253277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 N 3RD ST",
            "address_2": "SUITE 5B",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838143145",
            "telephone_number": "208-713-3463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 N 3RD ST",
            "address_2": "SUITE 5B",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838143145",
            "telephone_number": "208-713-3463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMING MINDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-02",
        "last_updated": "2015-10-16",
        "status": "A",
        "authorized_official_last_name": "STILES",
        "authorized_official_first_name": "CRISTINA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "208-713-3463",
        "authorized_official_credential": "SLP, MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-2231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1770954794",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1154671048",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Olivia Rose Blume, PA-C

• All providers in Coeur D Alene, ID
• Speech-Language Pathologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.