Individual provider Active NPI

Amanda Gold, MS, CCC-SLP

  • Speech-Language Pathologist
  • Tooele, UT
National Provider Identifier
1801672894
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8149594-4102 Issued in UT
Practice address
165 S Main St
Tooele, UT 84074-2127
Phone
(435) 833-0725
NPI assigned
Sep 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 8149594-4102 UT Primary

Addresses

Primary practice location

165 S Main St
Tooele, UT 84074-2127

Mailing address

192 Preakness Way
Tooele, UT 84074-8172
Phone (270) 703-4596

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
8149594-4102UTMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1801672894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 PREAKNESS WAY",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840748172",
            "telephone_number": "270-703-4596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 S MAIN ST",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840742127",
            "telephone_number": "435-833-0725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLD",
        "first_name": "AMANDA",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "UT",
            "license": "8149594-4102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tooele, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.