Active NPI
Amanda Henry
- Speech-Language Pathologist
- Beckley, WV
National Provider Identifier
1811169204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1107
- Practice address
- 105 Adair St
Beckley, WV 25801-3733 - Phone
- (304) 256-4712
- NPI assigned
- Mar 26, 2008
- 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 | 1107 | WV | Primary |
Addresses
Primary practice location
105 Adair St
Beckley, WV 25801-3733
Mailing address
105 Adair St
Beckley, WV 25801-3733
Phone (304) 256-4712
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810009003 | Medicaid | WV |
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 |
|---|---|---|---|
| 1107 | WV | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Raleigh County | Past | 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.
-
- Local Education Agency (LEA)
- Beckley, WV
- NPI 1841406162
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206489600000",
"number": "1811169204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 ADAIR ST",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258013733",
"telephone_number": "304-256-4712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 ADAIR ST",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258013733",
"telephone_number": "304-256-4712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRY",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-26",
"last_updated": "2008-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WV",
"license": "1107",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810009003",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beckley, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.