Individual provider Active NPI

Amanda Fleck, MA, CCC-SLP

  • Speech-Language Pathologist
  • Evansville, IN
National Provider Identifier
1215791405
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22006916A Issued in IN
Practice address
3001 Galaxy Dr
Evansville, IN 47715-1687
Phone
(812) 485-2822
NPI assigned
Feb 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 22006916A IN Primary

Addresses

Primary practice location

3001 Galaxy Dr
Evansville, IN 47715-1687

Mailing address

3001 Galaxy Dr
Evansville, IN 47715-1687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240214002406 IN Practitioner - Qualified Speech Language Pathologist 4183068471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Outpatient Rehabilitation Services LLCGroup PAC ID 8022272848, 199 clinicians

Practice addresses (Care Compare)

3109 E Bristol St
C/O Brentwood at Elkhart Assisted Living
Elkhart, IN 46514-4372
Phone (574) 584-3231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
22006916AINMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Jan 10, 2024 Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Jan 10, 2024 Accepting new patients

Locations

525 Bentee Wes Ct
Evansville, IN 47715
Phone (812) 471-3100

303 N Hurstbourne Pkwy
Ste 200
Louisville, KY 40222
Phone (502) 213-7572

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1707350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1215791405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 GALAXY DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477151687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 GALAXY DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477151687",
            "telephone_number": "812-485-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLECK",
        "first_name": "AMANDA",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-08",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22006916A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.