Amanda Joleen Frederick, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

271026 Issued in KY

Practice address

11840 Commonwealth Dr
Louisville, KY 40299-2309

Phone

(502) 633-1007

NPI assigned

May 31, 2021

Last updated

Jun 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1622419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1477129526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 HOWARD DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658138",
            "telephone_number": "502-320-3318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11840 COMMONWEALTH DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992309",
            "telephone_number": "502-633-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "AMANDA",
        "middle_name": "JOLEEN",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-31",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "271026",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "46003900A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Frazier
• Miranda Frazier, RBT
• Alexis Paige Frazine
• Fred Look, P.S.C., D.M.D.
• Timothy Freda, PHARMD
• Carmen Sue Frederick
• Carrie Anna Frederick, APRN
• Emily Kirchner Frederick, PHARM.D.
• Jennifer Lee Frederick, CRNA
• Tonya Frederick

• Speech-Language Pathologist in Louisville, KY
• Providers in Louisville, KY by specialty
• Speech-Language Pathologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.