Amanda Newton Ketchersid, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP#1991 Issued in AR

Practice address

2997 Highway 222
Leola, AR 72084-8843

Phone

(501) 626-9675

NPI assigned

Nov 25, 2008

Sex

Female

Sole proprietor

Yes

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.

• Meridian Rehab Partners

  • Speech-Language Pathologist
  • Leola, AR
  • NPI 1982000881
  NPD (past) Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 2, 2015.

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441152000000",
    "number": "1154576676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2997 HIGHWAY 222",
            "city": "LEOLA",
            "state": "AR",
            "postal_code": "720848843",
            "telephone_number": "501-626-9675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2997 HIGHWAY 222",
            "city": "LEOLA",
            "state": "AR",
            "postal_code": "720848843",
            "telephone_number": "501-626-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHERSID",
        "first_name": "AMANDA",
        "middle_name": "NEWTON",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-25",
        "last_updated": "2015-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#1991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meridian Rehab Partners

• All providers in Leola, AR
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; 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.