Amanda Renee North, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202008092 Issued in VA

Practice address

4803 Horseman Dr NE
Roanoke, VA 24019-5642

Phone

(765) 437-4976

NPI assigned

Jul 7, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Miss Amanda Renee Stephens Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1164805347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4803 HORSEMAN DR NE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240195642",
            "telephone_number": "765-437-4976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4803 HORSEMAN DR NE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240195642",
            "telephone_number": "765-437-4976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTH",
        "first_name": "AMANDA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2023-11-27",
        "certification_date": "2020-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "4168-154",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202008092",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "9511",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22005045A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amandan@bluemountaintherapy.com",
            "affiliation": "Y",
            "endpointDescription": "Encrypted & secure email address",
            "affiliationName": "Blue Mountain Therapy, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "27018 Lee Hwy",
            "city": "Abingdon",
            "state": "VA",
            "country_code": "US",
            "postal_code": "242117512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "STEPHENS",
            "middle_name": "RENEE",
            "prefix": "MISS",
            "credential": "M.A. CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.