Amanda Jean Peters, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

116037 Issued in TX

Practice address

128 E Olin Ave
Madison, WI 53713-1467

Phone

(608) 252-1320

Fax

(608) 252-1333

NPI assigned

Aug 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Family Service Madison Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, WI
  • NPI 1881806198
  NPD
• Hhu Xtra Care Inc

  • Home Infusion Therapy Pharmacy
  • Madison, WI
  • NPI 1326337106
  NPD (past)

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1104436708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 RANCH ROAD 2222 APT 1318",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787303214",
            "telephone_number": "224-703-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 E OLIN AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537131467",
            "telephone_number": "608-252-1320",
            "fax_number": "608-252-1333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9737 Great Hills Trl Ste 120",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787596418",
            "country_code": "US",
            "telephone_number": "512-872-2180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "AMANDA",
        "middle_name": "JEAN",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-07",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "116037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES",
            "identifier": "6093",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter C. Jackson, PSYD Consulting, SC
• Katherine Lindsay Peterangelo, MS, CCC-SLP
• Cierra Peterlin, RD
• Barbara Ann Peterman, CRNA
• James Peterman
• David Kellogg Peters, M.D., PH.D.
• Emma Peters, PHARMD
• Kelly Peters, RN
• Megan E Peters, M.D.
• Sarah Amanda Peters, MS, OTR

• Speech-Language Pathologist in Madison, WI
• Providers in Madison, WI by specialty
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.