Active NPI
Amanda Lopez
- Speech-Language Pathologist
- Longmont, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP.0005036
- Practice address
- 711 Darby CT Apt 205
Longmont, CO 80501-5076 - Phone
- (612) 770-1709
- NPI assigned
- Jan 16, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP.0005036 | CO | Primary |
Addresses
Primary practice location
711 Darby CT Apt 205
Longmont, CO 80501-5076
Mailing address
711 Darby CT Apt 205
Longmont, CO 80501-5076
Phone (612) 770-1709
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240208000730 | CO | Practitioner - Qualified Speech Language Pathologist | 1658714597 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Legacy Healthcare Services IncHealthpro Heritage Rehab and Fitness LLC
Practice addresses (Care Compare)
2310 9TH Ave
Longmont, CO 80503-4008
Phone (303) 834-8426
4950 Thunderbird Dr
Boulder, CO 80303-3835
Phone (720) 778-2767
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthpro Heritage Rehab & Fitness, LLC | Speech-Language Pathologist | Current | Accepting new patients |
| Legacy Healthcare Services Inc. | Speech-Language Pathologist | Current | Accepting new patients |
| Healthpro Heritage Rehab & Fitness, LLC | Speech-Language Pathologist | Current | Accepting new patients |
| Legacy Healthcare Services Inc | Speech-Language Pathologist | Current | Accepting new patients |
Locations
4950 Thunderbird Dr
Boulder, CO 80303
Phone (303) 499-4888
110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300
Organizations & group practices 26
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673827200000",
"number": "1043925944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 DARBY CT APT 205",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805015076",
"telephone_number": "612-770-1709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 DARBY CT APT 205",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805015076",
"telephone_number": "612-770-1709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-16",
"last_updated": "2023-01-16",
"certification_date": "2023-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CO",
"license": "SLP.0005036",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Longmont, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.