Individual provider Active NPI

Amanda Lymangood, M.A. CCC-SLP

  • Speech-Language Pathologist
  • St Louis Park, MN
National Provider Identifier
1295041077
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8835 Issued in MN
Practice address
7900 W 28TH St
St Louis Park, MN 55426-3011
Phone
(952) 920-3859
NPI assigned
Aug 31, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

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 8835 MN Primary
Speech-Language Pathologist 235Z00000X 3394 WI

Addresses

Primary practice location

7900 W 28TH St
St Louis Park, MN 55426-3011

Mailing address

7900 W 28TH St
St Louis Park, MN 55426-3011
Phone (952) 920-8380

Other names 1

  • Amanda Grantham Former name

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 Arts

State licenses

LicenseStateTypeSpecialty
8835MNMDSpeech-Language Pathologist
3394WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321315200000",
    "number": "1295041077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 W 28TH ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554263011",
            "telephone_number": "952-920-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 W 28TH ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554263011",
            "telephone_number": "952-920-3859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYMANGOOD",
        "first_name": "AMANDA",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-31",
        "last_updated": "2011-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "8835",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "3394",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "GRANTHAM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.