Northwest Pediatric Speech Therapy, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

NORTHWEST PEDIATRIC SPEECH THERAPY, LLC

Practice address

1130 W Hayden Ave Ste 103
Hayden, ID 83835-8720

Phone

(208) 660-9463

Fax

(208) 908-0044

NPI assigned

Jun 19, 2020

Organization subpart

No

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

Authorized official

Name

Megan McMaster-Stine, CCC-SLPNPI 1740793405

Title

Speech-Language Pathologist

Phone

(208) 660-9463

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Megan Leigh McMaster-Stine, CCC-SLP

  • Speech-Language Pathologist
  • Hayden, ID
  • NPI 1740793405
  NPD Authorized official

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688083200000",
    "number": "1760008262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 W HAYDEN AVE STE 103",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358720",
            "telephone_number": "208-660-9463",
            "fax_number": "208-908-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 W HAYDEN AVE STE 103",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358720",
            "telephone_number": "208-660-9463",
            "fax_number": "208-908-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PEDIATRIC SPEECH THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-19",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A",
        "authorized_official_last_name": "MCMASTER-STINE",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "208-660-9463",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740793405",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Hayden, ID
• Providers in Hayden, 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 Jun 30, 2023; 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.