Individual provider Active NPI

Madasyn Epp

  • Student in an Organized Health Care Education/Training Program
  • Amarillo, TX
National Provider Identifier
1558847004
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
114698 Issued in TX
Practice address
1250 Wallace Blvd
Amarillo, TX 79106-1741
Phone
(806) 353-3596
Fax
(806) 353-4927
NPI assigned
Jul 18, 2018
Last updated
Aug 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 114698 TX Primary
Speech-Language Pathologist 235Z00000X 114698 TX

Addresses

Primary practice location

1250 Wallace Blvd
Amarillo, TX 79106-1741

Mailing address

1250 Wallace Blvd
Amarillo, TX 79106-1741
Phone (806) 353-3596

Other identifiers 1

IdentifierTypeStateIssuer
114698OtherTXTEXAS DEPARTMENT OF LICENSING AND REGULATION

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

State licenses

LicenseStateTypeSpecialty
114698TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Turn Center Speech-Language Pathologist Past Accepting new patients

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": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1558847004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061741",
            "telephone_number": "806-353-3596",
            "fax_number": "806-353-4927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061741",
            "telephone_number": "806-353-3596",
            "fax_number": "806-353-4927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPP",
        "first_name": "MADASYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "114698",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "114698",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS DEPARTMENT OF LICENSING AND REGULATION",
            "identifier": "114698",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; 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.