Individual provider Active NPI

Amy Kennedy Thomas, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Orlando, FL
National Provider Identifier
1861537243
Registry record updated Mar 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 8916 Issued in FL
Practice address
22 Lake Beauty Dr
Suite 304
Orlando, FL 32806-2037
Phone
(407) 924-5430
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2013

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 SA 8916 FL Primary

Addresses

Primary practice location

22 Lake Beauty Dr
Suite 304
Orlando, FL 32806-2037

Mailing address

2518 Chippewa TRL
Maitland, FL 32751-4045
Phone (407) 924-5430

Other identifiers 2

IdentifierTypeStateIssuer
890769200MedicaidFL
SA 8916OtherFLSTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100726000862 FL Practitioner - Qualified Speech Language Pathologist 4789759747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3280 Progress Dr
Suite 500
Orlando, FL 32826-2903
Phone (407) 882-0468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SA 8916FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Central Florida Board of Trustees CurrentSince Feb 12, 2018 Accepting new patients
The University of Central Florida Board of Trustees Speech-Language Pathologist Current Accepting new patients
Word of Mouth LLC Speech-Language Pathologist Past Accepting new patients

Locations

3280 Progress Dr
Ste 500
Orlando, FL 32826
Phone (407) 882-0468

3400 Quadrangle Blvd
Orlando, FL 32817
Phone (407) 266-3627

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363046400000",
    "number": "1861537243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 CHIPPEWA TRL",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514045",
            "telephone_number": "407-924-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 LAKE BEAUTY DR",
            "address_2": "SUITE 304",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062037",
            "telephone_number": "407-924-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "AMY",
        "middle_name": "KENNEDY",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2013-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 8916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890769200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "SA 8916",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.