Individual provider Active NPI

Nancy Stockton, M.S.

  • Speech-Language Pathologist
  • Eagle, ID
National Provider Identifier
1689954315
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
TSLP-2148 Issued in ID
Practice address
935 E Winding Creek Dr Ste 120
Eagle, ID 83616-7242
Phone
(208) 938-4748
Fax
(208) 938-1710
NPI assigned
Aug 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X TSLP-2148 ID Primary

Addresses

Primary practice location

935 E Winding Creek Dr Ste 120
Eagle, ID 83616-7242

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
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
TSLP-2148IDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Boise Speech Tree, LLC Speech-Language Pathologist CurrentSince Jul 6, 2022 Accepting new patients

Locations

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

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314230400000",
    "number": "1689954315",
    "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": "935 E WINDING CREEK DR STE 120",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836167242",
            "telephone_number": "208-938-4748",
            "fax_number": "208-938-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKTON",
        "first_name": "NANCY",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-25",
        "last_updated": "2011-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "TSLP-2148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; 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.