Amanda Rose Maxim, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

1104 Bob McCullough Dr
Ashland, KY 41102-9275

Phone

(606) 928-4141

NPI assigned

Aug 20, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Boyd County Board of Education

  dba Summit Elementary School

  • Public Health or Welfare Agency
  • Ashland, KY
  • NPI 1225209281
  NPD (past)

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1073093092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8114 COUNTRY VIEW DR",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411029738",
            "telephone_number": "304-216-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 BOB MCCULLOUGH DR",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411029275",
            "telephone_number": "606-928-4141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "522 Glenwood Ave",
            "address_purpose": "LOCATION",
            "city": "New Boston",
            "state": "OH",
            "postal_code": "456625505",
            "country_code": "US",
            "telephone_number": "740-354-7761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAXIM",
        "first_name": "AMANDA",
        "middle_name": "ROSE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mathew.P.Samuel,MD PSC
• Khan Matin, MD
• Matthew J Pierzala DO PSC
• Maurice J. Oakley,M.D.,P.S.C.
• Melissa Jo Mavis, ARNP
• Crystal Mayes
• Angela Maynard
• Breanna Maynard
• David Maynard, CSW
• Isabella Maynard

• Speech-Language Pathologist in Ashland, KY
• Providers in Ashland, 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 Mar 6, 2020; 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.