Amanda Broadstreet, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP1061 Issued in AR

Practice address

1000 W Poplar St
Rogers, AR 72756-4242

Phone

(479) 631-7678

NPI assigned

Mar 30, 2007

Last updated

Sep 27, 2024By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Post 0218, PLC

  dba POST Pediatric Therapies

  • Physical Therapy Clinic/Center
  • Rogers, AR
  • NPI 1679617427
  NPD
• Carr Therapies LLS

  • Speech-Language Pathologist
  • Fayetteville, AR
  • NPI 1215945175
  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1508986647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W POPLAR ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727564242",
            "telephone_number": "479-631-7678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W POPLAR ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727564242",
            "telephone_number": "479-631-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADSTREET",
        "first_name": "AMANDA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP1061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162451721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brighter Day Ar LLC
• Jordyn Brill, O.T.
• Leigh Brill
• Ruby Brindley, PHARM. D.
• Hannah Leigh Brizzolara, MS, RD, LD
• William Jordan Brockway, MD
• Darren L Brodie, O.D.
• Kelsey Brodie
• Brook Smith, LLC
• Brooke a. Bisbee, DPM, PA (Family Foot Health Center, PA)

• Speech-Language Pathologist in Rogers, AR
• Providers in Rogers, AR by specialty
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.