Amanda's SLP Care LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.011341 Issued in IL

Legal business name

AMANDA'S SLP CARE LLC

Practice address

8 Eagle Ctr Ste 5
O Fallon, IL 62269-1947

Phone

(618) 334-4550

Fax

(877) 418-7178

NPI assigned

Oct 23, 2013

Last updated

Feb 27, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda Johnson, MS,CCC-SLPNPI 1154642148

Title

Owner

Phone

(618) 334-4550

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amanda Johnson

  • Speech-Language Pathologist
  • O'Fallon, IL
  • NPI 1154642148
  Authorized official Same address or phone

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424995200000",
    "number": "1457789786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 EAGLE CTR STE 5",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691947",
            "telephone_number": "618-334-4550",
            "fax_number": "877-418-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 EAGLE CTR STE 5",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691947",
            "telephone_number": "618-334-4550",
            "fax_number": "877-418-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANDA'S SLP CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-23",
        "last_updated": "2015-02-27",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-334-4550",
        "authorized_official_credential": "MS,CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.011341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in O'Fallon, IL
• Providers in O'Fallon, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2015; 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.