Individual provider Active NPI

Emilee Soderquist

  • Social Worker
  • Rexburg, ID
National Provider Identifier
1679363139
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
8871458 Issued in ID
Practice address
33 Madison Professional Park
Rexburg, ID 83440-2057
Phone
(208) 243-9304
NPI assigned
May 8, 2025
Last updated
May 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 8871458 ID Primary

Addresses

Primary practice location

33 Madison Professional Park
Rexburg, ID 83440-2057

Mailing address

33 Madison Professional Park
Rexburg, ID 83440-2057

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8871458IDMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1746662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1679363139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 MADISON PROFESSIONAL PARK",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 MADISON PROFESSIONAL PARK",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402057",
            "telephone_number": "208-243-9304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODERQUIST",
        "first_name": "EMILEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-08",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "8871458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rexburg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; 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.