Amanda Johnston Talley, MCD, CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2646 Issued in KY

Practice address

300 Westwood St
Glasgow, KY 42141-1030

Phone

(270) 779-7131

NPI assigned

Jan 26, 2016

Sex

Female

Sole proprietor

No

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, last updated by the provider on Jan 26, 2016.

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1497112197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 PLAYERS CROSSING WAY",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421045534",
            "telephone_number": "270-779-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WESTWOOD ST",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411030",
            "telephone_number": "270-779-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLEY",
        "first_name": "AMANDA",
        "middle_name": "JOHNSTON",
        "name_prefix": "Mrs.",
        "credential": "MCD, CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "2646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.