Individual provider Active NPI

Amy Tang

  • Speech-Language Pathologist
  • Clarksburg, MD
National Provider Identifier
1922965920
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202011396 Issued in VA
Practice address
12614 Piedmont Trail Rd
Clarksburg, MD 20871-4303
Phone
(301) 525-2661
Fax
(855) 678-8887
NPI assigned
Jan 9, 2026
Last updated
Jan 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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 2202011396 VA Primary

Addresses

Primary practice location

12614 Piedmont Trail Rd
Clarksburg, MD 20871-4303

Mailing address

12614 Piedmont Trail Rd
Clarksburg, MD 20871-4303
Phone (301) 525-2661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20260204004029 DC Practitioner - Qualified Speech Language Pathologist 2264911841 Reassigns benefits to 3 organizations
I20260209000731 VA Practitioner - Qualified Speech Language Pathologist 2264911841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prestige Rehab VA PLLCGroup PAC ID 1951841758, 9 clinicians
The Temple Foundation IncGroup PAC ID 4486630985, 16 clinicians
Proflex Physical Therapy of Maryland, LLCGroup PAC ID 7416244322, 41 clinicians

Practice addresses (Care Compare)

2807 N Parham Rd
Suite 320
Henrico, VA 23294-4458
Phone (855) 678-8887

4299 Chantilly Shopping Ctr Dr
Suite 104
Chantilly, VA 20151-4025
Phone (703) 844-0690

9207 Arlington Blvd
Fairfax, VA 22031-2501
Phone (855) 678-8887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2202011396VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Temple Foundation Inc CurrentSince Feb 10, 2026 Accepting new patients
Prestige Rehab VA PLLC Speech-Language Pathologist CurrentSince Jan 16, 2026 Accepting new patients

Locations

4299 Chantilly Shopping Center Dr
Ste 104
Chantilly, VA 20151
Phone (703) 844-0690

3020 Hamaker Ct
Ste 100
Fairfax, VA 22031
Phone (703) 844-8599

2807 N Parham Rd
Ste 320
Richmond, VA 23294
Phone (571) 275-5935

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1767916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1922965920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12614 PIEDMONT TRAIL RD",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208714303",
            "telephone_number": "301-525-2661",
            "fax_number": "855-678-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12614 PIEDMONT TRAIL RD",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208714303",
            "telephone_number": "301-525-2661",
            "fax_number": "855-678-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANG",
        "first_name": "AMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-09",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202011396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; 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.