Individual provider Active NPI

Amanda Waterman

  • Speech-Language Pathologist
  • Murray, UT
National Provider Identifier
1518775063
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
14031489-4104 Issued in UT
Practice address
5770 S 250 E Ste G50
Murray, UT 84107-6165
Phone
(801) 314-5000
NPI assigned
Dec 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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 14031489-4104 UT Primary

Addresses

Primary practice location

5770 S 250 E Ste G50
Murray, UT 84107-6165

Mailing address

PO Box 25537
Salt Lake City, UT 84125-0537

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250417002504 UT Practitioner - Qualified Speech Language Pathologist 7911422399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

5770 S 250
Suite G50
Murray, UT 84107-6165
Phone (801) 314-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14031489-4104UTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Mar 7, 2025 Accepting new patients
Ihc Health Services, Inc. CurrentSince Mar 7, 2025 Accepting new patients

Locations

5171 S Cottonwood St
Ste 900
Salt Lake City, UT 84107
Phone (801) 507-2050

5770 S 250 E
Ste G50
Salt Lake Cty, UT 84107
Phone (801) 314-4440

Organizations & group practices 2

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": "1735516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1518775063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25537",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 S 250 E STE G50",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076165",
            "telephone_number": "801-314-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-30",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "UT",
            "license": "14031489-4104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.