Individual provider Active NPI

Amanda Brea Powell

  • Speech-Language Assistant
  • San Tan Valley, AZ
National Provider Identifier
1457785909
Registry record updated Sep 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SLPA8514 Issued in AZ
Practice address
31645 N Royal Oak Way
San Tan Valley, AZ 85143-6341
Phone
(480) 677-3349
NPI assigned
Sep 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SLPA8514 AZ Primary

Addresses

Primary practice location

31645 N Royal Oak Way
San Tan Valley, AZ 85143-6341

Mailing address

7831 E Culver St
Mesa, AZ 85207-1205

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

LicenseStateTypeSpecialty
SLPA8514AZMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Essential Therapy Solutions, LLC Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1377993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377993600000",
    "number": "1457785909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7831 E CULVER ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852071205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31645 N ROYAL OAK WAY",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851436341",
            "telephone_number": "480-677-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "AMANDA",
        "middle_name": "BREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-01",
        "last_updated": "2013-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA8514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Tan Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2013; 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.