Individual provider Active NPI

Amy Hull Dickson, MHA, MS, CCC-SLP

  • Speech-Language Pathologist
  • Charleston, SC
National Provider Identifier
1114113651
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3138 Issued in SC
Practice address
520 Folly Rd
Suite P-152
Charleston, SC 29412-3019
Phone
(843) 478-7918
NPI assigned
Sep 19, 2007
Last updated
Oct 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3138 SC Primary

Addresses

Primary practice location

520 Folly Rd
Suite P-152
Charleston, SC 29412-3019

Mailing address

520 Folly Rd
Suite P-152
Charleston, SC 29412-3019
Phone (843) 478-7918

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 Science

State licenses

LicenseStateTypeSpecialty
3138SCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Speech at Home LLC Speech-Language Pathologist CurrentSince Oct 5, 2012 Accepting new patients

Locations

520 Folly Rd
#P152
Charleston, SC 29412
Phone (843) 478-7918

520 Folly Rd
Ste P152
Charleston, SC 29412
Phone (843) 478-7918

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1114113651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 FOLLY RD",
            "address_2": "SUITE P-152",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123019",
            "telephone_number": "843-478-7918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 FOLLY RD",
            "address_2": "SUITE P-152",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123019",
            "telephone_number": "843-478-7918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "AMY",
        "middle_name": "HULL",
        "credential": "MHA, MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-19",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "3138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; 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.