Active NPI
Amanda Carole Stark, M.S.
- Speech-Language Pathologist
- Salt Lake City, UT
National Provider Identifier
1649535022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 8345344-4104
- Practice address
- 729 Arapeen Dr
Salt Lake City, UT 84108-1218 - Phone
- (801) 587-8368
- NPI assigned
- Jul 11, 2012
- 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 | 8345344-4104 | UT | Primary |
Addresses
Primary practice location
729 Arapeen Dr
Salt Lake City, UT 84108-1218
Mailing address
729 Arapeen Dr
Salt Lake City, UT 84108-1218
Phone (801) 587-8368
Other practice location 1
440 D St Ste 320
Salt Lake City, UT 84103-2817
Phone (801) 408-4972
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | aheller54428@direct.med.utah.edu | Direct | University of Utah |
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8345344-4104 | UT | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637280000000",
"number": "1649535022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "729 ARAPEEN DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841081218",
"telephone_number": "801-587-8368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "729 ARAPEEN DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841081218",
"telephone_number": "801-587-8368"
}
],
"practiceLocations": [
{
"address_1": "440 D St Ste 320",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "841032817",
"country_code": "US",
"telephone_number": "801-408-4972",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STARK",
"first_name": "AMANDA",
"middle_name": "CAROLE",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-11",
"last_updated": "2021-11-19",
"certification_date": "2021-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "UT",
"license": "8345344-4104",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "aheller54428@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "University of Utah",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320100",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.