Amanda Carlson
Individual provider Active NPI Speech-Language Pathologist · York, NE
NPI 1265940720 · NPPES record last updated Jan 18, 2018
Key facts
- NPI
- 1265940720
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 1831 (NE)
- Practice address
- 2222 N Lincoln Ave
York, NE 68467-1030 - Phone
- (402) 362-6671
- NPI assigned
- Jan 18, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1831 | NE | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1831 | NE | Yes |
Addresses
Primary practice location
2222 N Lincoln Ave
York, NE 68467-1030
Mailing address
2222 N Lincoln Ave
York, NE 68467-1030
NPI Registry JSON
{
"created_epoch": "1516233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516233600000",
"number": "1265940720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2222 N LINCOLN AVE",
"city": "YORK",
"state": "NE",
"postal_code": "684671030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2222 N LINCOLN AVE",
"city": "YORK",
"state": "NE",
"postal_code": "684671030",
"telephone_number": "402-362-6671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-18",
"last_updated": "2018-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NE",
"license": "1831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.