Individual provider Active NPI

Amanda Rodriguez, M.S., CCC-SLP

  • Speech-Language Pathologist
  • The Woodlands, TX
National Provider Identifier
1447747902
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
106189 Issued in TX
Practice address
4055 Technology Forest Blvd Ste 100
The Woodlands, TX 77381-2008
Phone
(832) 463-2480
Fax
(832) 416-7577
NPI assigned
Apr 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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 106189 TX Primary

Addresses

Primary practice location

4055 Technology Forest Blvd Ste 100
The Woodlands, TX 77381-2008

Mailing address

6160 Cornerstone CT E Ste 100
San Diego, CA 92121-3724
Phone (858) 216-8837

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
106189TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pathfinder Pediatrics Home Care, LLC PastSince Mar 3, 2024 Accepting new patients
Cortica ABA Therapies PA PastSince Apr 6, 2023 Accepting new patients
Cortica Developmental Therapies PA PastSince Apr 6, 2023 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1447747902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6160 CORNERSTONE CT E STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213724",
            "telephone_number": "858-216-8837",
            "fax_number": "619-941-0276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 TECHNOLOGY FOREST BLVD STE 100",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773812008",
            "telephone_number": "832-463-2480",
            "fax_number": "832-416-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "AMANDA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-19",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "106189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.