Amanda Ruth Lane, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3125 Issued in KY

Practice address

867 McGuire Ave
Paducah, KY 42001-4036

Phone

(270) 442-6168

Fax

(270) 443-6211

NPI assigned

Jun 28, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Amanda Ruth Mathis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003013590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1186 HALE SPRINGS RD",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420254713",
            "telephone_number": "270-252-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "867 MCGUIRE AVE",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420014036",
            "telephone_number": "270-442-6168",
            "fax_number": "270-443-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "AMANDA",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "3125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12501490",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "MATHIS",
            "middle_name": "RUTH",
            "prefix": "MISS",
            "credential": "M.S. CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wynn Lancaster-Brown, MS
• Karen Lancaster-Williams
• Landals Speech Pathology, PLLC
• Remonica Landals, M.S., CCC-SLP
• Alexa Paige Landis Wilkins, LCSW
• Natasha Danielle Belt Lane, APRN
• Olivia Langham, LPCC
• Olivia Lanier
• Paul Lanier
• Beverly A Largent, D.M.D.

• Speech-Language Pathologist in Paducah, KY
• Providers in Paducah, KY by specialty
• Speech-Language Pathologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.