Active NPI
Amanda Marie Blackwell, SLP-CFY
- Speech-Language Pathologist
- Richardson, TX
National Provider Identifier
1285930263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 106488
- Practice address
- 320 Custer Road
Richardson, TX 75080 - Phone
- (972) 490-9055
- Fax
- (972) 490-9058
- NPI assigned
- Feb 8, 2011
- Sex
- Female
- Sole proprietor
- No
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 | 106488 | TX | Primary |
Addresses
Primary practice location
320 Custer Road
Richardson, TX 75080
Mailing address
320 Custer Road
Richardson, TX 75080
Phone (972) 490-9055
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 |
|---|---|---|---|
| 106488 | TX | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Warren Center, Inc | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Richardson, TX
- NPI 1538214200
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316476800000",
"number": "1285930263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 CUSTER ROAD",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "75080",
"telephone_number": "972-490-9055",
"fax_number": "972-490-9058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 CUSTER ROAD",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "75080",
"telephone_number": "972-490-9055",
"fax_number": "972-490-9058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKWELL",
"first_name": "AMANDA",
"middle_name": "MARIE",
"credential": "SLP-CFY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-08",
"last_updated": "2011-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "106488",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richardson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.