NPIMap

Organization Active NPI

Amy Shandy, Speech-Language Pathologist, LLC

Doing business as The Shandy Clinic

  • Speech-Language Pathologist
  • Monument, CO
National Provider Identifier
1922613264
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
AMY SHANDY, SPEECH-LANGUAGE PATHOLOGIST, LLC
Doing business as
The Shandy Clinic
Practice address
17230 Jackson Creek Pkwy Ste 220
Monument, CO 80132-7304
Phone
(719) 597-0822
Fax
(719) 599-4606
NPI assigned
Sep 14, 2020
Last updated
Sep 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Authorized official

Name
Rebecca Newman
Title
Billing Manager
Phone
(719) 597-0822

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU Primary
Behavior Analyst 103K00000X NU

Addresses

Primary practice location

17230 Jackson Creek Pkwy Ste 220
Monument, CO 80132-7304

Mailing address

685 Citadel Dr E Ste 580
Colorado Springs, CO 80909-5381
Phone (719) 597-0822

Other identifiers 1

IdentifierTypeStateIssuer
12000256MedicaidCO

Other names 1

  • THE SHANDY CLINIC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Amy Shandy Speech Language Pathologist33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600128000000",
    "number": "1922613264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 CITADEL DR E STE 580",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095381",
            "telephone_number": "719-597-0822",
            "fax_number": "719-599-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17230 JACKSON CREEK PKWY STE 220",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801327304",
            "telephone_number": "719-597-0822",
            "fax_number": "719-599-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY SHANDY, SPEECH-LANGUAGE PATHOLOGIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A",
        "authorized_official_last_name": "NEWMAN",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "719-597-0822"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12000256",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE SHANDY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THE SHANDY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monument, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.