Active NPI
Amy Sherman Mitchell, SLP
- Speech-Language Pathologist
- Holly Ridge, NC
National Provider Identifier
1407088313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5378
- Practice address
- 207 Oak Ridge LN
Holly Ridge, NC 28445-7946 - Phone
- (109) 554-8014
- NPI assigned
- Aug 12, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | 5378 | NC | Primary |
Addresses
Primary practice location
207 Oak Ridge LN
Holly Ridge, NC 28445-7946
Mailing address
207 Oak Ridge LN
Holly Ridge, NC 28445-7946
Phone (910) 554-8014
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 |
|---|---|---|---|
| 5378 | NC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587340800000",
"number": "1407088313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 OAK RIDGE LN",
"city": "HOLLY RIDGE",
"state": "NC",
"postal_code": "284457946",
"telephone_number": "910-554-8014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 OAK RIDGE LN",
"city": "HOLLY RIDGE",
"state": "NC",
"postal_code": "284457946",
"telephone_number": "109-554-8014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "AMY",
"middle_name": "SHERMAN",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-12",
"last_updated": "2020-04-20",
"certification_date": "2020-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "5378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holly Ridge, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.