Individual provider Active NPI

Kerry Anne Kearl, SLP

  • Speech-Language Pathologist
  • Ammon, ID
National Provider Identifier
1962683946
Registry record updated Nov 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP-1591 Issued in ID
Practice address
1675 Curlew Dr
Ammon, ID 83406-4718
Phone
(208) 529-4300
Fax
(208) 529-1627
NPI assigned
Nov 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2007

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 SLP-1591 ID Primary

Addresses

Primary practice location

1675 Curlew Dr
Ammon, ID 83406-4718

Mailing address

1675 Curlew Dr
Ammon, ID 83406-4718
Phone (208) 529-4300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240228002533 ID Practitioner - Qualified Speech Language Pathologist 2567807639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MHD Therapies PLLCGroup PAC ID 7113201831, 4 clinicians

Practice addresses (Care Compare)

36 Professional PLZ
Suite 110
Rexburg, ID 83440-2049
Phone (208) 359-9570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SLP-1591IDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
MHD Therapies, PLLC Speech-Language Pathologist CurrentSince Dec 16, 2023 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": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1962683946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 CURLEW DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834064718",
            "telephone_number": "208-529-4300",
            "fax_number": "208-529-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 CURLEW DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834064718",
            "telephone_number": "208-529-4300",
            "fax_number": "208-529-1627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARL",
        "first_name": "KERRY",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-1591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ammon, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.