Individual provider Active NPI

Amanda Brimlow, PSY.D

  • Specialist
  • Surprise, AZ
National Provider Identifier
1881013480
Registry record updated Apr 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4427 Issued in AZ
Practice address
12425 West Bell Rd
Suite 200
Surprise, AZ 85378
Phone
(623) 374-7774
NPI assigned
Apr 10, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 4427 AZ Primary

Addresses

Primary practice location

12425 West Bell Rd
Suite 200
Surprise, AZ 85378

Mailing address

12425 West Bell Rd
Suite 200
Surprise, AZ 85378
Phone (623) 374-7774

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

LicenseStateTypeSpecialty
4427AZMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397088000000",
    "number": "1881013480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12425 WEST BELL RD",
            "address_2": "SUITE 200",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "85378",
            "telephone_number": "623-374-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12425 WEST BELL RD",
            "address_2": "SUITE 200",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "85378",
            "telephone_number": "623-374-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIMLOW",
        "first_name": "AMANDA",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-10",
        "last_updated": "2014-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "4427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2014; 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.