Individual provider Active NPI

Amy Williams, MS, CCC-SLP

  • Speech-Language Pathologist
  • Tallahassee, FL
National Provider Identifier
1770955015
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA15202 Issued in FL
Practice address
2712 Via Milano Ave # B
Tallahassee, FL 32303-3289
Phone
(386) 688-3480
NPI assigned
Oct 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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 SZ7401 FL
Speech-Language Pathologist 235Z00000X SA15202 FL Primary

Addresses

Primary practice location

2712 Via Milano Ave # B
Tallahassee, FL 32303-3289

Mailing address

602 Vonderburg Dr Ste 201
Brandon, FL 33511-5900
Phone (813) 653-1149

Other practice location 1

602 Vonderburg Dr Ste 201
Brandon, FL 33511-5900
Phone (813) 653-1149

Other practice location 2

1215 Kingsley Ave
Orange Park, FL 32073-4631
Phone (904) 269-8922

Other identifiers 1

IdentifierTypeStateIssuer
021814800MedicaidFL

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 Science

State licenses

LicenseStateTypeSpecialty
SA15202FLMDSpeech-Language Pathologist
SZ7401FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Talkative Tallahassee, LLC Speech-Language Pathologist CurrentSince Jan 29, 2023 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1770955015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 VONDERBURG DR STE 201",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115900",
            "telephone_number": "813-653-1149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2712 VIA MILANO AVE # B",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323033289",
            "telephone_number": "386-688-3480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 Vonderburg Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335115900",
            "country_code": "US",
            "telephone_number": "813-653-1149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 Kingsley Ave",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320734631",
            "country_code": "US",
            "telephone_number": "904-269-8922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "AMY",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-27",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ7401",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA15202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021814800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.