Individual provider Active NPI

Amy Michelle Rodabaugh, SLPA

  • Speech-Language Assistant
  • Phoenix, AZ
National Provider Identifier
1942086178
Registry record updated Sep 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SLPA14455 Issued in AZ
Practice address
4153 W Sunnyside Ave
Phoenix, AZ 85029-3055
Phone
(602) 367-7565
NPI assigned
Sep 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SLPA14455 AZ Primary

Addresses

Primary practice location

4153 W Sunnyside Ave
Phoenix, AZ 85029-3055

Mailing address

4153 W Sunnyside Ave
Phoenix, AZ 85029-3055
Phone (602) 367-7565

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
SLPA14455AZMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1693785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1942086178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4153 W SUNNYSIDE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293055",
            "telephone_number": "602-367-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4153 W SUNNYSIDE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293055",
            "telephone_number": "602-367-7565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODABAUGH",
        "first_name": "AMY",
        "middle_name": "MICHELLE",
        "credential": "SLPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-04",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA14455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2023; 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.