BLAKE EDES (NPI# 1184194789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184194789 |
| Entity Type | Individual |
| Full Name | BLAKE EDES |
| Practice Address |
13075 W Persimmon Ln Ste 120 Boise ID 83713-1986 |
| Mailing Address |
4628 W Pasadena Ln Apt 101 Boise ID 83705-6527 |
| Practice Telephone | 2087937006 |
| Practice Fax Number | 2087937007 |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2020-03-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | SLP-4067 | ID | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 263162410 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 101 11th Ave S Ste 155, Nampa, ID 836513918 | 2084661077 | |
| 7091 W Emerald St, Boise, ID 837048618 | 2088981368 |
| Street Address |
13075 W PERSIMMON LN STE 120 |
| City | BOISE |
| State | ID |
| Zip Code | 83713-1986 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770063521 | Stephanie M Thomas | Speech-Language Pathologist | 13075 W Persimmon Ln Ste 120, Boise, ID 83713-1986 | 2018-08-20 |
| 1609484575 | Natalie Nielsen Whicker | Speech-Language Pathologist | 13075 W Persimmon Ln Ste 120, Boise, ID 83713-1986 | 2020-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265902332 | Kidscare Home Health of Idaho, LLC | Home Health | 1835 Wildwood Street, Boise, ID 83713 | 2018-11-30 |
| 1417463928 | Kimberly Ann Bohrer | Behavioral Analyst | 12053 W Hickory Dr, Boise, ID 83713 | 2017-12-19 |
| 1407371891 | Emir Hadzic | Optometrist | 13239 W. Fernleaf St., Boise, ID 83713 | 2017-08-07 |
| 1518336650 | Alliance Physical Medicine | Nurse Practitioner | 13909 W Wainwright Drive, Boise, ID 83713 | 2015-09-18 |
| 1083038335 | Jan L Rehder | Nurse Practitioner | 13150 W Persimmon Lane, Boise, ID 83713 | 2014-02-06 |
| 1508287061 | Heather N Fox | Physician Assistant | 12273 West Mcmillan Road, Boise, ID 83713 | 2013-12-30 |
| 1659667459 | Jayson Clark | Dentist | 4274 N Eagle Road, Boise, ID 83713 | 2011-06-21 |
| 1043503659 | Steven Anthony Eckhoff | Physician Assistant | 11662 W Arlen St, Boise, ID 83713 | 2011-05-16 |
| 1790923621 | Christie Dudash Flynn | Physician Assistant | 12273 W Mcmillian Road, Boise, ID 83713 | 2009-01-30 |
| 1699930404 | Dennis J. Garpetti, Dds, P.C. | Dentist | 13108 West Persimmon Lane, Boise, ID 83713 | 2008-07-21 |
| Find all providers in zip 83713 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417573809 | Jaclyn Christine Harmon | Speech-Language Pathologist | 8620 W Emerald St Ste 100, Boise, ID 83704-4838 | 2020-06-22 |
| 1770063521 | Stephanie M Thomas | Speech-Language Pathologist | 13075 W Persimmon Ln Ste 120, Boise, ID 83713-1986 | 2018-08-20 |
| 1285128546 | Sara Bergsma Speech Pathology, LLC | Speech-Language Pathologist | 10873 W Seneca Dr, Boise, ID 83709-3946 | 2018-06-20 |
| 1689168445 | Boise Speech Tree, LLC | Speech-Language Pathologist | 1015 W Hays St Ste 104, Boise, ID 83702-5412 | 2018-06-15 |
| 1598257651 | Kelly Marie Howard | Speech-Language Pathologist | 4120 N Creswell Way, Boise, ID 83713-2403 | 2018-06-05 |
| 1265937551 | Agave Speech and Language Services LLC | Speech-Language Pathologist | 1747 N Fairmeadow Dr, Boise, ID 83704-7007 | 2018-03-28 |
| 1134663008 | Kara Marie Nixon | Speech-Language Pathologist | 6289 S Hollyhock Way, Boise, ID 83716-7077 | 2016-12-13 |
| 1619349545 | Carla Motley | Speech-Language Pathologist | 1720 N Westgate Dr Ste D, Boise, ID 83704-7164 | 2015-10-30 |
| 1093181257 | Leslie Ann Johnson | Speech-Language Pathologist | 13176 W Persimmon Ln Ste 120, Boise, ID 83713-5027 | 2015-08-11 |
| 1023415171 | Christy Baltazor | Speech-Language Pathologist | 2127 W Overland Rd, Boise, ID 83705-3149 | 2014-12-03 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.