Active NPI
Amanda Purnell
- Speech-Language Pathologist
- Destin, FL
National Provider Identifier
1801268545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA 13708
- Practice address
- 195 Mattie M Kelly Blvd
Destin, FL 32541-2811 - Phone
- (850) 654-4588
- NPI assigned
- Oct 21, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | SA 13708 | FL | Primary |
Addresses
Primary practice location
195 Mattie M Kelly Blvd
Destin, FL 32541-2811
Mailing address
195 Mattie M Kelly Blvd
Destin, FL 32541-2811
Phone (850) 654-4588
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA 13708 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445385600000",
"number": "1801268545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "195 MATTIE M KELLY BLVD",
"city": "DESTIN",
"state": "FL",
"postal_code": "325412811",
"telephone_number": "850-654-4588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "195 MATTIE M KELLY BLVD",
"city": "DESTIN",
"state": "FL",
"postal_code": "325412811",
"telephone_number": "850-654-4588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURNELL",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-21",
"last_updated": "2015-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA 13708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Destin, FL
- Premier Allergist of Florida LLC (Allervie Health)
- Patrick Michael Pritchett, MOTR/L
- Harmony Rose Proffitt
- Publix Super Markets Inc (Publix Pharmacy #0677)
- Publix Super Markets, Inc. (Publix Pharmacy #2023)
- Jason Qualley, MD, CCP,LP
- Quinn Physical Therapy P.a.
- John E Quinn, M.S., P.T.
- Michael E Raim, O.D.
- Erica Ratanothayanon, PHARMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.