Active NPI
Amanda Johnson
- Speech-Language Pathologist
- O Fallon, IL
National Provider Identifier
1154642148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 8 Eagle Ctr Ste 5
O Fallon, IL 62269-1947 - Phone
- (618) 334-4550
- NPI assigned
- Jun 14, 2010
- 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 | Primary |
Addresses
Primary practice location
8 Eagle Ctr Ste 5
O Fallon, IL 62269-1947
Mailing address
8 Eagle Ctr Ste 5
O Fallon, IL 62269-1947
Phone (618) 334-4550
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424044800000",
"number": "1154642148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 EAGLE CTR STE 5",
"city": "O FALLON",
"state": "IL",
"postal_code": "622691947",
"telephone_number": "618-334-4550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 EAGLE CTR STE 5",
"city": "O FALLON",
"state": "IL",
"postal_code": "622691947",
"telephone_number": "618-334-4550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-14",
"last_updated": "2015-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in O Fallon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.