Active NPI
Amanda Duron Reid, CCC, SLP
- Speech-Language Pathologist
- Waco, TX
National Provider Identifier
1851733687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 105024
- Practice address
- 6610 Interstate 35 N
Waco, TX 76705-1136 - Phone
- (254) 235-7604
- Fax
- (254) 235-7612
- NPI assigned
- Jul 22, 2013
- 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 | 105024 | TX | Primary |
Addresses
Primary practice location
6610 Interstate 35 N
Waco, TX 76705-1136
Mailing address
6610 Interstate 35 N
Waco, TX 76705-1136
Phone (254) 235-7604
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12119811 | Other | TX | ASHA |
| 62115 | Other | TX | TSHA |
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 |
|---|---|---|---|
| 105024 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A to Z Rehab at Home | Past | Accepting new patients | |
| A to Z Rehab Services | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Home Health Agency
- Waco, TX
- NPI 1578802344
-
- Rehabilitation Clinic/Center
- Waco, TX
- NPI 1881957389
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374451200000",
"number": "1851733687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6610 INTERSTATE 35 N",
"city": "WACO",
"state": "TX",
"postal_code": "767051136",
"telephone_number": "254-235-7604",
"fax_number": "254-235-7612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6610 INTERSTATE 35 N",
"city": "WACO",
"state": "TX",
"postal_code": "767051136",
"telephone_number": "254-235-7604",
"fax_number": "254-235-7612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REID",
"first_name": "AMANDA",
"middle_name": "DURON",
"credential": "CCC, SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-22",
"last_updated": "2013-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "105024",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHA",
"identifier": "12119811",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TSHA",
"identifier": "62115",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.