Amethyst Neuropsychology PLLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

AMETHYST NEUROPSYCHOLOGY PLLC

Practice address

4505 N Illinois St Ste 7
Swansea, IL 62226-1500

Phone

(618) 680-0317

NPI assigned

Sep 16, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Sarah M Dyer, PHDNPI 1043877475

Title

Clinical Neuropsychologist

Phone

(618) 680-0317

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sarah Mailander Dyer, PHD

  • Clinical Neuropsychologist
  • Belleville, IL
  • NPI 1043877475
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1093542904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 N ILLINOIS ST STE 7",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622261500",
            "telephone_number": "618-680-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 N ILLINOIS ST STE 7",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622261500",
            "telephone_number": "618-680-0317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMETHYST NEUROPSYCHOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "DYER",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL NEUROPSYCHOLOGIST",
        "authorized_official_telephone_number": "618-680-0317",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Swansea, IL
• Clinical Neuropsychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.