Individual provider Active NPI

Amanda Lange, SLP

  • Speech-Language Pathologist
  • Austin, TX
National Provider Identifier
1639307929
Registry record updated Jun 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
104483 Issued in TX
Practice address
1611 Headway Cir
Austin, TX 78754-5160
Phone
(512) 615-7123
NPI assigned
Jun 25, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2009

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 104483 TX Primary

Addresses

Primary practice location

1611 Headway Cir
Austin, TX 78754-5160

Mailing address

816 Sheraton Ave
Austin, TX 78745-2044
Phone (979) 885-9785

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
104483TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245888000000",
    "number": "1639307929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 SHERATON AVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787452044",
            "telephone_number": "979-885-9785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 HEADWAY CIR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787545160",
            "telephone_number": "512-615-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "AMANDA",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2009-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "104483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; 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.