Active NPI
Amy Deters, SLP
- Speech-Language Pathologist
- Perry, IA
National Provider Identifier
1104027416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 01612
- Practice address
- 2625 Iowa St
Perry, IA 50220-2413 - Phone
- (615) 896-6400
- NPI assigned
- May 31, 2007
- 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 | 01612 | IA | Primary |
Addresses
Primary practice location
2625 Iowa St
Perry, IA 50220-2413
Mailing address
225 Prairie View Dr
5312
West Des Moines, IA 50266-7114
Phone (515) 250-0198
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 |
|---|---|---|---|
| 01612 | IA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104027416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 PRAIRIE VIEW DR",
"address_2": "5312",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502667114",
"telephone_number": "515-250-0198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2625 IOWA ST",
"city": "PERRY",
"state": "IA",
"postal_code": "502202413",
"telephone_number": "615-896-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETERS",
"first_name": "AMY",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IA",
"license": "01612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Perry, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.