Active NPI
Amanda Michelle Caudill
- Speech-Language Pathologist
- Lebanon, TN
National Provider Identifier
1962955047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4953
- Practice address
- 163 Business Park Dr Ste 11
Lebanon, TN 37090-1248 - Phone
- (615) 443-4445
- NPI assigned
- Jul 26, 2016
- 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 | 4953 | TN | Primary |
Addresses
Primary practice location
163 Business Park Dr Ste 11
Lebanon, TN 37090-1248
Mailing address
163 Business Park Dr.
Suite 11
Lebanon, TN 37090
Phone (615) 443-4445
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4953 | TN | MD | Certified Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469491200000",
"number": "1962955047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "163 BUSINESS PARK DR.",
"address_2": "SUITE 11",
"city": "LEBANON",
"state": "TN",
"postal_code": "37090",
"telephone_number": "615-443-4445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "163 BUSINESS PARK DR STE 11",
"city": "LEBANON",
"state": "TN",
"postal_code": "370901248",
"telephone_number": "615-443-4445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAUDILL",
"first_name": "AMANDA",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-26",
"last_updated": "2016-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TN",
"license": "4953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.