Active NPI
Amanda Newberry, SLP
- Speech-Language Pathologist
- Ada, OK
National Provider Identifier
1558615567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3519
- Practice address
- 1921 Stonecipher Dr
Ada, OK 74820 - Phone
- (580) 436-3980
- NPI assigned
- Oct 30, 2012
- Last updated
- Aug 17, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 3519 | OK | Primary |
Addresses
Primary practice location
1921 Stonecipher Dr
Ada, OK 74820
Mailing address
1921 Stonecipher Dr
Ada, OK 74820-3439
Phone (580) 436-3980
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1921 Stonecipher Dr
Ada, OK 74820-3439
Phone (580) 436-3980
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3519 | OK | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chickasaw Nation Division of Health Chickasaw Nation Medical Center | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Chickasaw Nation Medical Center
- General Acute Care Hospital
- Ada, OK
- NPI 1255364923
TX
-
dba Chickasaw Nation DME
- Durable Medical Equipment & Medical Supplies
- Ada, OK
- NPI 1295399095
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534464000000",
"number": "1558615567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1921 STONECIPHER DR",
"city": "ADA",
"state": "OK",
"postal_code": "748203439",
"telephone_number": "580-436-3980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1921 STONECIPHER DR",
"city": "ADA",
"state": "OK",
"postal_code": "74820",
"telephone_number": "580-436-3980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWBERRY",
"first_name": "AMANDA",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-30",
"last_updated": "2018-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "3519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ada, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.