Active NPI
Amanda Olson
- Speech-Language Pathologist
- Ithaca, NY
National Provider Identifier
1083149033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 026620
- Practice address
- 3226 Wilkins Rd
Ithaca, NY 14850-9568 - Phone
- (607) 272-5891
- Fax
- (607) 272-0188
- NPI assigned
- Apr 27, 2017
- Sex
- Female
- Sole proprietor
- No
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 | 026620 | NY | Primary |
Addresses
Primary practice location
3226 Wilkins Rd
Ithaca, NY 14850-9568
Mailing address
3226 Wilkins Rd
Ithaca, NY 14850-9568
Phone (607) 272-5891
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026620 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698883200000",
"number": "1083149033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3226 WILKINS RD",
"city": "ITHACA",
"state": "NY",
"postal_code": "148509568",
"telephone_number": "607-272-5891",
"fax_number": "607-272-0188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3226 WILKINS RD",
"city": "ITHACA",
"state": "NY",
"postal_code": "148509568",
"telephone_number": "607-272-5891",
"fax_number": "607-272-0188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-27",
"last_updated": "2023-11-02",
"certification_date": "2023-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "026620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.