Amy Lee Deichert, MS-SP-CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA 574 Issued in FL

Practice address

3627 University Blvd S
Suite 210
Jacksonville, FL 32216-4230

Phone

(904) 399-5311

Fax

(904) 396-2520

NPI assigned

Apr 30, 2013

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)

Enrolled

State licenses

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1083059315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6318 FALBRIDGE CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322589435",
            "telephone_number": "904-318-3159",
            "fax_number": "904-396-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 UNIVERSITY BLVD S",
            "address_2": "SUITE 210",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164230",
            "telephone_number": "904-399-5311",
            "fax_number": "904-396-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEICHERT",
        "first_name": "AMY",
        "middle_name": "LEE",
        "credential": "MS-SP-CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-30",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Degree Wellness LLC
• Alysha Marina Degrove, DNP
• Joshua Phillip Dehart, MD
• Mary Elizabeth Dehay, ARNP
• Savanna Dehner
• Judy L Deitrick, OPTICIAN
• Elizabeth Dejesus, PTA
• Mayra Dejesus, ARNP
• Bryana Dejoie
• Amber Renee Dekoschak, MD

• Speech-Language Pathologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.