Individual provider Active NPI

Amy Leider, MS/CCC-SLP

  • Speech-Language Pathologist
  • Charlottesville, VA
National Provider Identifier
1154553840
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202003436 Issued in VA
Practice address
417 Emmet St S
Charlottesville, VA 22903-2424
Phone
(434) 924-0542
NPI assigned
Aug 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202003436 VA Primary
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

417 Emmet St S
Charlottesville, VA 22903-2424

Mailing address

1061 Ramblewood PL
Charlottesville, VA 22901-1291
Phone (434) 964-1855

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 Science

State licenses

LicenseStateTypeSpecialty
2202003436VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1154553840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 RAMBLEWOOD PL",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229011291",
            "telephone_number": "434-964-1855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 EMMET ST S",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229032424",
            "telephone_number": "434-924-0542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIDER",
        "first_name": "AMY",
        "credential": "MS/CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-14",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202003436",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; 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.