Individual provider Active NPI

Amanda Summer Sorensen, M.S CF-SLP

  • Speech-Language Pathologist
  • Plano, TX
National Provider Identifier
1407576390
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
120146 Issued in TX
Practice address
4000 Eagle Pass
Plano, TX 75023-4705
Phone
(469) 752-4300
NPI assigned
Aug 31, 2022
Last updated
Aug 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 120146 TX Primary

Addresses

Primary practice location

4000 Eagle Pass
Plano, TX 75023-4705

Mailing address

2401 Aspen St
Richardson, TX 75082-3326
Phone (210) 334-5055

Other identifiers 1

IdentifierTypeStateIssuer
23MedicaidTX

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 Science

State licenses

LicenseStateTypeSpecialty
120146TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Plano Independent School District Current 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1407576390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 ASPEN ST",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750823326",
            "telephone_number": "210-334-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 EAGLE PASS",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750234705",
            "telephone_number": "469-752-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "AMANDA",
        "middle_name": "SUMMER",
        "credential": "M.S CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "120146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.