Active NPI
Amanda Lynn Gay, SLP
- Speech-Language Pathologist
- Hattiesburg, MS
National Provider Identifier
1831491687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- S2814
- Practice address
- 102 Medical Park
Hattiesburg, MS 39401-9080 - Phone
- (601) 261-5159
- Fax
- (601) 579-5240
- NPI assigned
- Nov 30, 2010
- 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 | S2814 | MS | Primary |
Addresses
Primary practice location
102 Medical Park
Hattiesburg, MS 39401-9080
Mailing address
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 261-5159
Other practice location 1
4109 Highway 98 W
Summit, MS 39666-9132
Phone (601) 276-3900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03689700 | Medicaid | MS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | agay113131@directpatientrecord.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S2814 | MS | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hattiesburg Clinic PA | Current | Accepting new patients | |
| Hattiesburg Clinic, PA | Current | Accepting new patients | |
| Hattiesburg Clinic PA | Current | Accepting new patients | |
| Hattiesburg Clinic, PA | Past | Accepting new patients | |
| State of Mississippi - University of Mississippi Medical Center | Past | Accepting new patients |
Locations
415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606
102 Medical Park
Ste B
Hattiesburg, MS 39401
Phone (601) 261-1650
102 Medical Park
Hattiesburg, MS 39401
Phone (601) 261-1650
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Hattiesburg, MS
- NPI 1740213446
-
- Adolescent and Children Mental Health Clinic/Center
- Hattiesburg, MS
- NPI 1154410017
-
- Primary Care Clinic/Center
- Flowood, MS
- NPI 1912600354
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Laurel, MS
- NPI 1245263540
-
- Critical Access Hospital
- Lexington, MS
- NPI 1386630705
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631491200000",
"number": "1831491687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 S 28TH AVE",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394017246",
"telephone_number": "601-261-5159",
"fax_number": "601-579-5240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 MEDICAL PARK",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394019080",
"telephone_number": "601-261-5159",
"fax_number": "601-579-5240"
}
],
"practiceLocations": [
{
"address_1": "4109 Highway 98 W",
"address_purpose": "LOCATION",
"city": "Summit",
"state": "MS",
"postal_code": "396669132",
"country_code": "US",
"telephone_number": "601-276-3900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GAY",
"first_name": "AMANDA",
"middle_name": "LYNN",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-30",
"last_updated": "2021-09-13",
"certification_date": "2021-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MS",
"license": "S2814",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03689700",
"state": "MS"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "agay113131@directpatientrecord.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "102 Medical Park",
"city": "Hattiesburg",
"state": "MS",
"country_code": "US",
"postal_code": "394019080",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.