Individual provider Active NPI

Amie Michelle Teague, MA/CCC-SLP

  • Speech-Language Pathologist
  • Danville, VA
National Provider Identifier
1730150186
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202003828 Issued in VA
Practice address
159 Executive Dr Ste a
Danville, VA 24541-4160
Phone
(434) 228-1812
NPI assigned
Feb 1, 2006
Last updated
Jul 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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 6794 NC
Speech-Language Pathologist 235Z00000X 2202003828 VA Primary

Addresses

Primary practice location

159 Executive Dr Ste a
Danville, VA 24541-4160

Mailing address

PO Box 10864
Danville, VA 24543-5015
Phone (434) 228-1812

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200424000414 VA Practitioner - Qualified Speech Language Pathologist 7214024173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Speech and Occupational Therapy SpecialistsGroup PAC ID 4981034477, 5 clinicians

Practice addresses (Care Compare)

159 Executive Dr
Suite a
Danville, VA 24541-4160
Phone 4347997732105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6794NCMDSpeech-Language Pathologist
2202003828VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech & Occupational Therapy Specialists Speech-Language Pathologist CurrentSince Mar 1, 2020 Accepting new patients

Locations

159 Executive Dr
Ste A
Danville, VA 24541
Phone (434) 799-7732

Organizations & group practices 1

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1730150186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10864",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245435015",
            "telephone_number": "434-228-1812",
            "fax_number": "866-468-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 EXECUTIVE DR STE A",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245414160",
            "telephone_number": "434-228-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEAGUE",
        "first_name": "AMIE",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "MA/CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "6794",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202003828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.