Individual provider Active NPI

Amanda Marie Aguirre, MA, CCC-SLP

  • Speech-Language Pathologist
  • Colorado Springs, CO
National Provider Identifier
1578042412
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
0003803 Issued in CO
Practice address
1117 E Monument St
Colorado Springs, CO 80903-2858
Phone
(956) 778-6989
NPI assigned
Aug 10, 2018
Last updated
Jan 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 114885 TX
Speech-Language Pathologist 235Z00000X 0003803 CO Primary

Addresses

Primary practice location

1117 E Monument St
Colorado Springs, CO 80903-2858

Mailing address

1117 E Monument St
Colorado Springs, CO 80903-2858
Phone (956) 778-6989

Other practice location 1

12708 Riata Vista Cir Ste A106
Austin, TX 78727-7174
Phone (512) 795-2422

Other practice location 2

12708 Riata Vista Cir Ste A106
Austin, TX 78727
Phone (512) 795-2422

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 Arts

State licenses

LicenseStateTypeSpecialty
0003803COMDSpeech-Language Pathologist
114885TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Peas Therapy, LLC Speech-Language Pathologist CurrentSince Feb 7, 2021 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": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1578042412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 E MONUMENT ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809032858",
            "telephone_number": "956-778-6989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 E MONUMENT ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809032858",
            "telephone_number": "956-778-6989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12708 Riata Vista Cir Ste A106",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787277174",
            "country_code": "US",
            "telephone_number": "512-795-2422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12708 Riata Vista Cir Ste A106",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "78727",
            "country_code": "US",
            "telephone_number": "512-795-2422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGUIRRE",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-10",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "114885",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "0003803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.