Individual provider Active NPI

Amanda Marie Beach, SLP

  • Speech-Language Pathologist
  • Fayetteville, NC
National Provider Identifier
1588233449
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
15002 Issued in NC
Practice address
1289 Oliver St
Fayetteville, NC 28304-4450
Phone
(910) 483-8331
Fax
(910) 483-8335
NPI assigned
Jun 23, 2021
Last updated
Jan 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 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 15002 NC Primary

Addresses

Primary practice location

1289 Oliver St
Fayetteville, NC 28304-4450

Mailing address

PO Box 87294
Fayetteville, NC 28304-7294
Phone (910) 483-8331

Other practice location 1

120 Turner St
Southern Pines, NC 28387-7053
Phone (910) 483-8331

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220215002493 NC Practitioner - Qualified Speech Language Pathologist 5597158568 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Benefit Therapy Services, PLLC Speech-Language Pathologist CurrentSince Feb 7, 2022 Accepting new patients
Dymond Speech & Rehab., P.a. Speech-Language Pathologist PastSince Jun 1, 2021 Accepting new patients
Pediatric Developmental Therapy PastSince Sep 23, 2024 Accepting new patients
Pediatric Developmental Therapy Speech-Language Pathologist PastSince Sep 23, 2024 Accepting new patients

Locations

600A Village Walk Dr
Holly Springs, NC 27540
Phone (919) 285-2157

Organizations & group practices 4

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": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1588233449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87294",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283047294",
            "telephone_number": "910-483-8331",
            "fax_number": "910-483-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1289 OLIVER ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044450",
            "telephone_number": "910-483-8331",
            "fax_number": "910-483-8335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Turner St",
            "address_purpose": "LOCATION",
            "city": "Southern Pines",
            "state": "NC",
            "postal_code": "283877053",
            "country_code": "US",
            "telephone_number": "910-483-8331",
            "fax_number": "910-483-8335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEACH",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "15002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.