Mary Amanda Bullington, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202006193 Issued in VA

Practice address

2839 Bishop Creek Rd
Lynch Station, VA 24571-2445

Phone

(434) 941-8185

NPI assigned

Oct 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Amanda Bullington Cunningham Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Purposeful Play Pediatric Therapies LLC

  • Pediatric Occupational Therapist
  • Lynch Station, VA
  • NPI 1982331146

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1720705205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 FATHER JUDGE RD",
            "city": "MONROE",
            "state": "VA",
            "postal_code": "245742734",
            "telephone_number": "434-665-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2839 BISHOP CREEK RD",
            "city": "LYNCH STATION",
            "state": "VA",
            "postal_code": "245712445",
            "telephone_number": "434-941-8185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLINGTON",
        "first_name": "MARY",
        "middle_name": "AMANDA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202006193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY AMANDA",
            "last_name": "CUNNINGHAM",
            "middle_name": "BULLINGTON",
            "credential": "CCC-SLP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Centertown Pharmacy LLC
• Amy E. Johnson, DNP, FNP-C
• Purposeful Play Pediatric Therapies LLC
• Amanda Thompson

• Speech-Language Pathologist in Lynch Station, VA
• Providers in Lynch Station, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.