NPIMap

Organization Active NPI

Boise Speech Tree, LLC

  • Speech-Language Pathologist
  • Boise, ID
National Provider Identifier
1689168445
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP-1353 Issued in ID
Legal business name
BOISE SPEECH TREE, LLC
Practice address
1015 W Hays St Ste 104
Boise, ID 83702-5412
Phone
(208) 938-4748
Fax
(208) 938-1710
NPI assigned
Jun 15, 2018
Last updated
May 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Authorized official

Name
Shari Elizabeth Morrison-Doke, M.A.
Title
President
Phone
(208) 938-4748

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP-1353 ID Primary

Addresses

Primary practice location

1015 W Hays St Ste 104
Boise, ID 83702-5412

Mailing address

935 E Winding Creek Dr Ste 120
Eagle, ID 83616-7242
Phone (208) 938-4748

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200529001208 ID Part B Supplier - Clinic/Group Practice 1557782554 Receives reassigned benefits from 6 practitioners
Practice locations: Boise, ID; Eagle, ID

National Provider Directory

National Provider Directory

Locations

1015 W Hays St
Ste 103
Boise, ID 83702

1015 W Hays St
Ste 104
Boise, ID 83702
Phone (208) 830-9311

1409 W Main St
Ste 120
Boise, ID 83702
Phone (208) 370-5857

935 E Winding Creek Dr
Ste 120
Eagle, ID 83616
Phone (208) 938-4748

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589932800000",
    "number": "1689168445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 E WINDING CREEK DR STE 120",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836167242",
            "telephone_number": "208-938-4748",
            "fax_number": "208-938-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 W HAYS ST STE 104",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025412",
            "telephone_number": "208-938-4748",
            "fax_number": "208-938-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOISE SPEECH TREE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-15",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A",
        "authorized_official_last_name": "MORRISON-DOKE",
        "authorized_official_first_name": "SHARI",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-938-4748",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-1353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; 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.