Mallory Roberts

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP-4224 Issued in ID

Practice address

302 2ND Ave E
Twin Falls, ID 83301-6425

Phone

(208) 749-3475

NPI assigned

Feb 8, 2020

Last updated

Feb 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Clear Source Therapy and Clinical Resource Center LLC

  dba Clear Talk Speech Therapy LLC

  • Speech-Language Pathologist
  • Twin Falls, ID
  • NPI 1205571668
  NPD (past)
• Williams Chiropractic Pain Relief Clinic PC

  • Chiropractor
  • Twin Falls, ID
  • NPI 1346435856
  NPD (past)

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

{
    "created_epoch": "1581120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581120000000",
    "number": "1720610645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2662 JOSHUA WAY",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833018953",
            "telephone_number": "801-663-9765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 2ND AVE E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016425",
            "telephone_number": "208-749-3475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MALLORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-08",
        "last_updated": "2020-02-08",
        "certification_date": "2020-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-4224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kami Roach, LCPC
• Caleb E Roberts, D.P.M.
• James Morris Roberts
• John Charles Roberts, D.D.S.
• Lora K Roberts, N.P.
• Amanda Robertson, DPT
• Auston Robinson
• Branden Howard Robinson
• Elizabeth R Robinson, M. COUN.
• Kelsie Lyn Robinson, MED., LCPC

• Speech-Language Pathologist in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Speech-Language Pathologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2020; 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.