Individual provider Active NPI

Landon Brown, SLP-INTERN

  • Speech-Language Pathologist
  • Amarillo, TX
National Provider Identifier
1710337472
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
112449 Issued in TX
Practice address
720 S Tyler St
Amarillo, TX 79101-2313
Phone
(806) 651-5106
Fax
(806) 651-5105
NPI assigned
Jun 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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 112449 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X 112449 TX

Addresses

Primary practice location

720 S Tyler St
Amarillo, TX 79101-2313

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
112449OtherTXSTATE BOARD OF EXAMINERS FOR SPEECH LANGUAGE PATHOLOGY AND AUDIOLOGY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200819002606 TX Practitioner - Qualified Speech Language Pathologist 5092131144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Texas a and M UniversityGroup PAC ID 5092771618, 4 clinicians

Practice addresses (Care Compare)

2501 4TH Ave
Canyon, TX 79016-0001
Phone (806) 651-5108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112449TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
West Texas a & M University CurrentSince May 12, 2024 Accepting new patients
West Texas a&M University CurrentSince Sep 1, 2020 Accepting new patients

Locations

720 S Tyler St
Amarillo, TX 79101
Phone (806) 651-5101

60757 Wt Box
Canyon, TX 79016

2501 4th Ave
Canyon, TX 79016
Phone (806) 651-5101

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1710337472",
    "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": "720 S TYLER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791012313",
            "telephone_number": "806-651-5106",
            "fax_number": "806-651-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "LANDON",
        "credential": "SLP-INTERN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-14",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "112449",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "112449",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF EXAMINERS FOR SPEECH LANGUAGE PATHOLOGY AND AUDIOLOGY",
            "identifier": "112449",
            "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 May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.