Individual provider Active NPI

Amanda R McGavin

  • Speech-Language Pathologist
  • Pearland, TX
National Provider Identifier
1487835161
Registry record updated Nov 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
101379 Issued in TX
Practice address
8619 Broadway St Ste 200
Pearland, TX 77584-8496
Phone
(281) 485-4818
Fax
(481) 485-5446
NPI assigned
Nov 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2007

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 101379 TX Primary

Addresses

Primary practice location

8619 Broadway St Ste 200
Pearland, TX 77584-8496

Mailing address

8619 Broadway St Ste 200
Pearland, TX 77584-8496
Phone (281) 485-4818

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
101379TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Spot PLLC 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": "1195603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195603200000",
    "number": "1487835161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8619 BROADWAY ST STE 200",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775848496",
            "telephone_number": "281-485-4818",
            "fax_number": "481-485-5446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8619 BROADWAY ST STE 200",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775848496",
            "telephone_number": "281-485-4818",
            "fax_number": "481-485-5446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGAVIN",
        "first_name": "AMANDA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-21",
        "last_updated": "2007-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "101379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; 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.