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Active NPI 1215401963 Individual Practitioner Male Practitioner

Dylan Wake , MS CCC-SLP

Speech-Language Pathologist • Idaho Falls, ID

Professional Overview & Biography Verified Profile Summary

Dylan Wake, MS CCC-SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Idaho Falls, ID. Practice services are available at 3100 CHANNING WAY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3100 Channing Way

Idaho Falls, ID 834047533

Telephone 2085297685
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Idaho Falls, ID

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 17.9 Yrs
State Avg: 14.2 Yrs
Regional Practice Density
73 Specialists

Practicing in Idaho Falls, ID (967 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License ID SLP-3589

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Carl Brayton , DO

Student in an Organized Health Care Education/Training Program

NPI 1003617192

Doctor of Osteopathic Medicine (D.O.)

Reed Loertscher , CRNA

Nurse Anesthetist, Certified Registered

NPI 1013235951

Certified Registered Nurse Anesthetist

Alexis Siddoway , NP

Nurse Practitioner - Neonatal

NPI 1013352285

Nurse Practitioner

Dr. Venkata Kalyan Byrapogu , MD

Student in an Organized Health Care Education/Training Program

NPI 1013619832

Doctor of Medicine (M.D.)

Taylor Carson

Student in an Organized Health Care Education/Training Program

NPI 1013835859
Dr. Noor Nassef , DO

Student in an Organized Health Care Education/Training Program

NPI 1013855295

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active January 16, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location January 16, 2019

Registered at 3100 CHANNING WAY, IDAHO FALLS, ID 834047533 (Tel: 2085297685)

📍
Updated Business Mailing Address January 16, 2019

Registered at 3100 CHANNING WAY, IDAHO FALLS, ID 834047533 (Tel: 2085297685)

👤
Provider Name / Credentials Updated January 16, 2019

Recorded as DYLAN WAKE, M.S. CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 16, 2019

Speech-Language Pathologist (License #SLP-3589 in ID)

🟢
Initial NPI Registration & Enumeration January 16, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1215401963
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 16, 2019
Last Update: January 16, 2019
Sole Proprietor: No

Mailing Address

3100 Channing Way

Idaho Falls, ID 834047533

Phone: 2085297685

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.