Amy Kristine Pena, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

103610 Issued in TX

Practice address

101 Reese Dr
Red Oak, TX 75154-2376

Phone

(469) 552-0500

NPI assigned

Sep 19, 2018

Last updated

Sep 19, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1881178499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOLF RIDGE CT",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751650014",
            "telephone_number": "214-991-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 REESE DR",
            "city": "RED OAK",
            "state": "TX",
            "postal_code": "751542376",
            "telephone_number": "469-552-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "AMY",
        "middle_name": "KRISTINE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-19",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "103610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barack Austine Otieno, FNP-BC
• Parker & Chamblee LLC (Red Oak Urgent Care)
• Sunny Patel, MD
• Cassondra Patterson, COTA
• Corinne S Pearson, DENTIST
• Jason Scott Phillips, DC
• Rebeca E Piantini Alvarez, MD
• John Shawn Piper, RPH
• PMST Red Oak, LLC
• Lindsay Dawn Porter, MD

• Speech-Language Pathologist in Red Oak, TX
• Providers in Red Oak, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; 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.