Individual provider Active NPI

Amy Wickizer Piper, CCC

  • Speech-Language Pathologist
  • Bloomington, IN
National Provider Identifier
1811204654
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22003665A Issued in IN
Practice address
200 S Jordan Ave
Bloomington, IN 47405-7002
Phone
(812) 855-6251
NPI assigned
Aug 31, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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 22003665A IN Primary

Addresses

Primary practice location

200 S Jordan Ave
Bloomington, IN 47405-7002

Mailing address

5455 E Earl Young Rd
Bloomington, IN 47408-9521
Phone (812) 339-8939

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1811204654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 E EARL YOUNG RD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474089521",
            "telephone_number": "812-339-8939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S JORDAN AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474057002",
            "telephone_number": "812-855-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIPER",
        "first_name": "AMY",
        "middle_name": "WICKIZER",
        "credential": "CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-31",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22003665A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.