Active NPI
Amanda Jane Sutton, CCC-SLP
- Speech-Language Pathologist
- Reston, VA
National Provider Identifier
1194989525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2202005466
- Practice address
- 1818 Library St
Suite 500
Reston, VA 20190-5619 - Phone
- (703) 915-0804
- NPI assigned
- Jul 15, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 2202005466 | VA | Primary |
Addresses
Primary practice location
1818 Library St
Suite 500
Reston, VA 20190-5619
Mailing address
12000 Market St
#327
Reston, VA 20190-5693
Phone (703) 915-0804
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2202005466 | VA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216080000000",
"number": "1194989525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12000 MARKET ST",
"address_2": "#327",
"city": "RESTON",
"state": "VA",
"postal_code": "201905693",
"telephone_number": "703-915-0804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1818 LIBRARY ST",
"address_2": "SUITE 500",
"city": "RESTON",
"state": "VA",
"postal_code": "201905619",
"telephone_number": "703-915-0804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTTON",
"first_name": "AMANDA",
"middle_name": "JANE",
"name_prefix": "Mrs.",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-15",
"last_updated": "2008-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "VA",
"license": "2202005466",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Reston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.