Active NPI
Amanda Ketch
- Speech-Language Assistant
- Presque Isle, ME
National Provider Identifier
1447903315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SAS3488
- Practice address
- 44 Park St
Presque Isle, ME 04769-2140 - Phone
- (207) 764-3721
- NPI assigned
- Feb 1, 2022
- Sex
- Female
- Sole proprietor
- No
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 Assistant | 2355S0801X | SAS3488 | ME | Primary |
Addresses
Primary practice location
44 Park St
Presque Isle, ME 04769-2140
Mailing address
49 Court St
Houlton, ME 04730-2076
Phone (207) 329-0744
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SAS3488 | Medicaid | ME |
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 |
|---|---|---|---|
| SAS3488 | ME | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643673600000",
"number": "1447903315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49 COURT ST",
"city": "HOULTON",
"state": "ME",
"postal_code": "047302076",
"telephone_number": "207-329-0744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 PARK ST",
"city": "PRESQUE ISLE",
"state": "ME",
"postal_code": "047692140",
"telephone_number": "207-764-3721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KETCH",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-01",
"last_updated": "2022-02-01",
"certification_date": "2022-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "ME",
"license": "SAS3488",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SAS3488",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Presque Isle, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.