Individual provider Active NPI

Amanda Anne Neisner, MS, CCC/SLP

  • Speech-Language Pathologist
  • Piedmont, SD
National Provider Identifier
1548309685
Registry record updated May 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
13555 Frontier Loop
Piedmont, SD 57769
Phone
(605) 716-9529
Fax
(605) 716-9576
NPI assigned
Feb 5, 2007
Last updated
May 13, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2011

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 NU Primary

Addresses

Primary practice location

13555 Frontier Loop
Piedmont, SD 57769

Mailing address

13555 Frontier Loop
Piedmont, SD 57769
Phone (605) 716-9529

Other identifiers 1

IdentifierTypeStateIssuer
5836330MedicaidSD

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
Credentials
Master of Science

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

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305244800000",
    "number": "1548309685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13555 FRONTIER LOOP",
            "city": "PIEDMONT",
            "state": "SD",
            "postal_code": "57769",
            "telephone_number": "605-716-9529",
            "fax_number": "605-716-9576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13555 FRONTIER LOOP",
            "city": "PIEDMONT",
            "state": "SD",
            "postal_code": "57769",
            "telephone_number": "605-716-9529",
            "fax_number": "605-716-9576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEISNER",
        "first_name": "AMANDA",
        "middle_name": "ANNE",
        "credential": "MS, CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2011-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5836330",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Piedmont, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2011; 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.