Individual provider Active NPI

Lyndsey Evans

  • Speech-Language Pathologist
  • Eagle, ID
National Provider Identifier
1720464902
Registry record updated Oct 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP-3093 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 10, 2015
Last updated
Oct 24, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP-3093 ID Primary
Speech-Language Pathologist 235Z00000X TSLP-2777 ID

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
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190416002078 ID Practitioner - Qualified Speech Language Pathologist 8628319878 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SLP-3093IDMDSpeech-Language Pathologist
TSLP-2777IDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Boise Speech Tree, LLC Speech-Language Pathologist CurrentSince Jul 6, 2022 Accepting new patients
Chatterton Speech Therapy, LLC Speech-Language Pathologist CurrentSince Feb 22, 2021 Accepting new patients

Locations

13075 W Persimmon Ln
#120
Boise, ID 83713
Phone (208) 793-7006

8601 W Emerald St
Ste 150
Boise, ID 83704
Phone (208) 321-0634

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

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1720464902",
    "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": "EVANS",
        "first_name": "LYNDSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-10",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-3093",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "TSLP-2777",
            "primary": false
        }
    ],
    "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 Oct 24, 2016; 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.