Active NPI
Amy Suzanne Holzum, M.A. CCC/SLP
- Speech-Language Pathologist
- Carmel, IN
National Provider Identifier
1104499300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22004302A
- Practice address
- 118 Medical Dr
Carmel, IN 46032-3323 - Phone
- (317) 844-4211
- NPI assigned
- Jul 23, 2021
- 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 | 22004302A | IN | Primary |
Addresses
Primary practice location
118 Medical Dr
Carmel, IN 46032-3323
Mailing address
10913 Flower Mound PL
Fishers, IN 46037-7109
Phone (317) 410-8669
Other names 1
- Miss Amy Suzanne Tindall
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22004302A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626998400000",
"number": "1104499300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10913 FLOWER MOUND PL",
"city": "FISHERS",
"state": "IN",
"postal_code": "460377109",
"telephone_number": "317-410-8669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 MEDICAL DR",
"city": "CARMEL",
"state": "IN",
"postal_code": "460323323",
"telephone_number": "317-844-4211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLZUM",
"first_name": "AMY",
"middle_name": "SUZANNE",
"name_prefix": "Mrs.",
"credential": "M.A. CCC/SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-23",
"last_updated": "2021-07-23",
"certification_date": "2021-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22004302A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMY",
"last_name": "TINDALL",
"middle_name": "SUZANNE",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Carmel, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.