Active NPI
Kristen Wolfley, MSCCC-SLP
- Speech-Language Pathologist
- Star, ID
National Provider Identifier
1962746529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP-1175
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| SLP-1175 | ID | MD | Speech-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.