Individual provider Active NPI

Sara Emily Carter, SLP

  • Speech-Language Pathologist
  • Rexburg, ID
National Provider Identifier
1790046829
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
TSLP-2230 Issued in ID
Practice address
393 E 2ND N
Rexburg, ID 83440-1605
Phone
(208) 359-9570
NPI assigned
Jun 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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-2230 ID Primary

Addresses

Primary practice location

393 E 2ND N
Rexburg, ID 83440-1605

Mailing address

PO Box 711
Rexburg, ID 83440-0711
Phone (208) 359-9570

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180711003933 ID Practitioner - Qualified Speech Language Pathologist 5799031340 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TSLP-2230IDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
MHD Therapies, PLLC Speech-Language Pathologist CurrentSince Feb 1, 2017 Accepting new patients

Locations

36 Professional Plz
Ste 110
Rexburg, ID 83440
Phone (208) 359-9570

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": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1790046829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 711",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834400711",
            "telephone_number": "208-359-9570",
            "fax_number": "208-359-9580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 E 2ND N",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401605",
            "telephone_number": "208-359-9570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "SARA",
        "middle_name": "EMILY",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-05",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "TSLP-2230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rexburg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.