Active NPI
Amanda Henzler, M.A.
- Speech-Language Pathologist
- Blufftono, SC
National Provider Identifier
1750443586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP006221
- Practice address
- 29 Plantation Park Dr.
Suite 403
Blufftono, SC 29910-9001 - Phone
- (843) 815-6999
- Fax
- (843) 815-6998
- NPI assigned
- Dec 15, 2006
- Last updated
- Aug 4, 2011
- 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 | SLP006221 | GA | Primary |
Addresses
Primary practice location
29 Plantation Park Dr.
Suite 403
Blufftono, SC 29910-9001
Mailing address
29 Plantation Park Dr.
Suite 403
Bluffton, SC 29910-9001
Phone (843) 815-6999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 993218634A | Medicaid | GA |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP006221 | GA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lowcountry Therapy Center, LLC | Speech-Language Pathologist | Past | Accepting new patients |
| Lowcountry Center | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatric Occupational Therapist
- Bluffton, SC
- NPI 1255622056
-
- Speech-Language Pathologist
- Bluffton, SC
- NPI 1245554104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312416000000",
"number": "1750443586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 PLANTATION PARK DR.",
"address_2": "SUITE 403",
"city": "BLUFFTON",
"state": "SC",
"postal_code": "299109001",
"telephone_number": "843-815-6999",
"fax_number": "843-815-6998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 PLANTATION PARK DR.",
"address_2": "SUITE 403",
"city": "BLUFFTONO",
"state": "SC",
"postal_code": "299109001",
"telephone_number": "843-815-6999",
"fax_number": "843-815-6998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENZLER",
"first_name": "AMANDA",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-15",
"last_updated": "2011-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP006221",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "993218634A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.