NPIMap

Organization Active NPI

Amy Shandy, Speech-Language Pathologist, LLC

Doing business as The Shandy Clinic

  • Behavior Analyst
  • Fountain, CO
National Provider Identifier
1154936466
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
AMY SHANDY, SPEECH-LANGUAGE PATHOLOGIST, LLC
Doing business as
The Shandy Clinic
Practice address
901 N Santa Fe Ave
Fountain, CO 80817-1738
Phone
(719) 597-0822
Fax
(719) 597-0822
NPI assigned
Sep 14, 2020
Last updated
Sep 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Authorized official

Name
Rebecca Newman
Title
Billing Manager
Phone
(719) 597-0822

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

901 N Santa Fe Ave
Fountain, CO 80817-1738

Mailing address

685 Citadel Dr E Ste 580
Colorado Springs, CO 80909-5381

Other identifiers 1

IdentifierTypeStateIssuer
12000256MedicaidCO

Other names 1

  • THE SHANDY CLINIC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Amy Shandy Speech Language Pathologist33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600041600000",
    "number": "1154936466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 CITADEL DR E STE 580",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N SANTA FE AVE",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808171738",
            "telephone_number": "719-597-0822",
            "fax_number": "719-597-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY SHANDY, SPEECH-LANGUAGE PATHOLOGIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-10",
        "status": "A",
        "authorized_official_last_name": "NEWMAN",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "719-597-0822"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12000256",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE SHANDY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fountain, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.