NPIMap

Organization Active NPI

Mid Iowa Speech Therapy

  • Speech-Language Pathologist
  • Johnston, IA
National Provider Identifier
1871914002
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
471 Issued in IA
Legal business name
MID IOWA SPEECH THERAPY
Practice address
6850 Ceres Cir
Johnston, IA 50131-1657
Phone
(515) 314-3800
Fax
(515) 270-9376
NPI assigned
Dec 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2013

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

Authorized official

Name
Patricia Lynn Bole, MA. CCC SLP
Title
President
Phone
(515) 314-3800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 471 IA Primary

Addresses

Primary practice location

6850 Ceres Cir
Johnston, IA 50131-1657

Mailing address

6850 Ceres Cir
Johnston, IA 50131-1657
Phone (515) 314-3800

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1386892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386892800000",
    "number": "1871914002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6850 CERES CIR",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311657",
            "telephone_number": "515-314-3800",
            "fax_number": "515-270-9376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 CERES CIR",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311657",
            "telephone_number": "515-314-3800",
            "fax_number": "515-270-9376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID IOWA SPEECH THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-13",
        "last_updated": "2013-12-13",
        "status": "A",
        "authorized_official_last_name": "BOLE",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-314-3800",
        "authorized_official_credential": "MA. CCC SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; 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.