Amandarhea A Moore, MCD, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2939 Issued in AR

Practice address

1792 Falls Blvd N
Suite 4
Wynne, AR 72396-4092

Phone

(870) 261-5820

NPI assigned

Jan 5, 2011

Last updated

Jan 5, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Pediatric Speech Solutions, LLC

  • Speech-Language Pathologist
  • Wynne, AR
  • NPI 1427715986
  NPD (past)

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

{
    "created_epoch": "1294185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1255635223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 COUNTY ROAD 385",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723968075",
            "telephone_number": "870-261-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1792 FALLS BLVD N",
            "address_2": "SUITE 4",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723964092",
            "telephone_number": "870-261-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "AMANDARHEA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MCD, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-05",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "2939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amanda Noelle Mueller, OT
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• Rhonda Nelson
• Zachary Grant Nethercutt, CHILD/ ADULT CIS

• Speech-Language Pathologist in Wynne, AR
• Providers in Wynne, AR by specialty
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.