1003462748 NPI number — TAYLOR CHORD M.S.,CCC-SLP

NPI Number: 1003462748
Health Care Provider/Practitioner: TAYLOR CHORD M.S.,CCC-SLP

NPI Number : 1003462748 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1003462748",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CHORD",
    "FirstName": "TAYLOR",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.S.,CCC-SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "LEDBETTER",
    "OtherFirstName": "TAYLOR",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "M.S., CCC-SLP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "101 S ALLUMBAUGH WAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BOISE",
    "MailingAddressStateName": "ID",
    "MailingAddressPostalCode": "83709-5658",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "208-323-8888",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "245 N 3RD E",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MOUNTAIN HOME",
    "PracticeLocationAddressStateName": "ID",
    "PracticeLocationAddressPostalCode": "83647-2734",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "208-587-8255",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/16/2019",
    "LastUpdateDate": "04/08/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "235Z00000X",
        "TaxonomyName": "Speech-Language Pathologist",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}