Individual provider Active NPI

Amanda Sherrill Harriss, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Gastonia, NC
National Provider Identifier
1083698708
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7564 Issued in NC
Practice address
3644 Catawba Creek Dr
Gastonia, NC 28056-8393
Phone
(704) 879-4240
NPI assigned
Dec 6, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7564 NC Primary
Speech-Language Pathologist 235Z00000X IL

Addresses

Primary practice location

3644 Catawba Creek Dr
Gastonia, NC 28056-8393

Mailing address

3644 Catawba Creek Dr
Gastonia, NC 28056-8393
Phone (704) 879-4240

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
146006162ILMDSpeech-Language Pathologist
7564NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Great Therapy Group LLC Speech-Language Pathologist CurrentSince Aug 27, 2023 Accepting new patients

Locations

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

3389 Sheridan St
Hollywood, FL 33021
Phone (954) 247-8757

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1083698708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3644 CATAWBA CREEK DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280568393",
            "telephone_number": "704-879-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3644 CATAWBA CREEK DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280568393",
            "telephone_number": "704-879-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISS",
        "first_name": "AMANDA",
        "middle_name": "SHERRILL",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "7564",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.