Individual provider Active NPI

Amanda Budde, MA CCC SLP

  • Speech-Language Pathologist
  • Miamisburg, OH
National Provider Identifier
1295287837
Registry record updated May 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP.12591 Issued in OH
Practice address
4010 Crains Run Rd
Miamisburg, OH 45342-6245
Phone
(937) 847-2766
NPI assigned
Oct 31, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2019

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 COND.2016208-SP OH
Speech-Language Pathologist 235Z00000X SP.12591 OH Primary

Addresses

Primary practice location

4010 Crains Run Rd
Miamisburg, OH 45342-6245

Mailing address

4010 Crains Run Rd
Miamisburg, OH 45342-6245
Phone (937) 847-2766

Other identifiers 1

IdentifierTypeStateIssuer
1295287837MedicaidOH

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
COND.2016208-SPOHMDSpeech-Language Pathologist
SP.12591OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1295287837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 CRAINS RUN RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453426245",
            "telephone_number": "937-847-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 CRAINS RUN RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453426245",
            "telephone_number": "937-847-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDDE",
        "first_name": "AMANDA",
        "credential": "MA CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-31",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "COND.2016208-SP",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.12591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295287837",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miamisburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2019; 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.