Individual provider Active NPI

Kristen Wolfley, MSCCC-SLP

  • Speech-Language Pathologist
  • Star, ID
National Provider Identifier
1962746529
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP-1175 Issued in ID
Practice address
353 S Delphinium Ave
Star, ID 83669-5276
Phone
(208) 409-4597
NPI assigned
Nov 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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-1175 ID Primary

Addresses

Primary practice location

353 S Delphinium Ave
Star, ID 83669-5276

Mailing address

353 S Delphinium Ave
Star, ID 83669-5276
Phone (208) 409-4597

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260504006039 UT Practitioner - Qualified Speech Language Pathologist 9739657263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic and Neurological Rehab IncGroup PAC ID 6507159126, 368 clinicians

Practice addresses (Care Compare)

1425 S 1500
Clearfield, UT 84015-1621
Phone (512) 327-4444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SLP-1175IDMDSpeech-Language Pathologist

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": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1962746529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 S DELPHINIUM AVE",
            "city": "STAR",
            "state": "ID",
            "postal_code": "836695276",
            "telephone_number": "208-409-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 S DELPHINIUM AVE",
            "city": "STAR",
            "state": "ID",
            "postal_code": "836695276",
            "telephone_number": "208-409-4597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFLEY",
        "first_name": "KRISTEN",
        "name_prefix": "Mrs.",
        "credential": "MSCCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-20",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-1175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Star, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.