Individual provider Active NPI

Ami Cherith Dean, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Christiansbrg, VA
National Provider Identifier
1205120409
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202006309 Issued in VA
Practice address
620 Magna Carta Via
Christiansbrg, VA 24073-1470
Phone
(540) 616-7260
NPI assigned
Jun 6, 2011
Last updated
Sep 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 30000075 NC
Speech-Language Pathologist 235Z00000X 2202006309 VA Primary

Addresses

Primary practice location

620 Magna Carta Via
Christiansbrg, VA 24073-1470

Mailing address

620 Magna Carta Via
Christiansbrg, VA 24073-1470
Phone (540) 616-7260

Other practice location 1

210 Liberty Hill Rd
Lumberton, NC 28358-2442
Phone (540) 616-7260

Other identifiers 2

IdentifierTypeStateIssuer
30016196820002MedicaidVA
1205120409MedicaidNC

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
30000075NCMDSpeech-Language Pathologist
2202006309VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1205120409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 MAGNA CARTA VIA",
            "city": "CHRISTIANSBRG",
            "state": "VA",
            "postal_code": "240731470",
            "telephone_number": "540-616-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 MAGNA CARTA VIA",
            "city": "CHRISTIANSBRG",
            "state": "VA",
            "postal_code": "240731470",
            "telephone_number": "540-616-7260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Liberty Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Lumberton",
            "state": "NC",
            "postal_code": "283582442",
            "country_code": "US",
            "telephone_number": "540-616-7260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEAN",
        "first_name": "AMI",
        "middle_name": "CHERITH",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30000075",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202006309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30016196820002",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205120409",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Christiansbrg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.