Jeffrey D. Anderson, MS, CCC-SLP
NPI 1063684421ActiveIndividual· Speech-Language Pathologist· Rexburg, ID
Speech-Language Pathologist (MS, CCC-SLP) in Rexburg, Idaho, licensed in ID, with an NPI issued in March 2008. Enrolled in Medicare as practitioner - qualified speech language pathologist.
Overview
| NPI | 1063684421 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MS, CCC-SLP |
| Sole proprietor | Yes |
| NPI issued | Mar 26, 2008 |
| Last updated in NPPES | Sep 1, 2009 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | SLP-1119 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Speech Language Pathologist (ID) |
|---|
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