Amanda Green, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP2975 Issued in AR

Practice address

7830 Pine Forest Rd
Pensacola, FL 32526-8404

Phone

(850) 741-6715

Fax

(850) 204-0489

NPI assigned

Feb 23, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR, FL2 enrollments

Enrollment records 2

Specialty

Qualified Speech Language Pathologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Action Therapy Group LLCGroup PAC ID 6305258013, 69 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Action Therapy Group LLC

  • Physical Therapist
  • Jay, FL
  • NPI 1548861602
  Medicare reassignment Care Compare group NPD
• Boaz & Associates, Inc.

  dba Delta Rehab

  • Physical Therapy Clinic/Center
  • Wynne, AR
  • NPI 1518011816
  NPD (past)

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

{
    "created_epoch": "1487808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1497294409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 E BOBE ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325033962",
            "telephone_number": "850-741-6715",
            "fax_number": "850-204-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7830 PINE FOREST RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325268404",
            "telephone_number": "850-741-6715",
            "fax_number": "850-204-0489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 Eldridge Ave E",
            "address_purpose": "LOCATION",
            "city": "Wynne",
            "state": "AR",
            "postal_code": "723964032",
            "country_code": "US",
            "telephone_number": "870-208-8989",
            "fax_number": "870-208-8107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "AMANDA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-23",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP2975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA",
            "identifier": "14033060",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Great Strides Rehabilitation Inc. (Great Stride Rehabilitation)
• Greater Gulf Coast Primary Care LLC (Gulf Coast Primary Care)
• Greater Pensacola Behavior Services Inc
• Katie Greathouse, LCSW
• Allison Victoria Green, MSW
• Anna Green Cecile Green, RBT
• Ashley Green
• Julie Martin Green, MT-BC
• Lauren Davis Green
• Martha M Green, M.D.

• Speech-Language Pathologist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.