Active NPI
Amanda Paige Fry, MA.,CCC-SLP
- Speech-Language Pathologist
- Athens, TN
National Provider Identifier
1891867362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2930
- Practice address
- 1204 Frye St
Athens, TN 37303-3052 - Phone
- (423) 745-0434
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 2930 | TN | Primary |
Addresses
Primary practice location
1204 Frye St
Athens, TN 37303-3052
Mailing address
110 Wind Chase Dr
Madisonville, TN 37354-5820
Phone (423) 420-0621
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2930 | TN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891867362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 WIND CHASE DR",
"city": "MADISONVILLE",
"state": "TN",
"postal_code": "373545820",
"telephone_number": "423-420-0621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1204 FRYE ST",
"city": "ATHENS",
"state": "TN",
"postal_code": "373033052",
"telephone_number": "423-745-0434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRY",
"first_name": "AMANDA",
"middle_name": "PAIGE",
"credential": "MA.,CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TN",
"license": "2930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Athens, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.