Active NPI
Amanda Kern, MS CCC SLP
- Speech-Language Pathologist
- Smithton, IL
National Provider Identifier
1972016715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146.011039
- Practice address
- 107 S Lincoln St
Smithton, IL 62285-1617 - Phone
- (618) 235-4600
- NPI assigned
- Nov 15, 2017
- Last updated
- Nov 15, 2017
- 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 | 146.011039 | IL | Primary |
Addresses
Primary practice location
107 S Lincoln St
Smithton, IL 62285-1617
Mailing address
6489 Brand Lake Dr
Waterloo, IL 62298-3031
Phone (618) 246-7894
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.011039 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510704000000",
"number": "1972016715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6489 BRAND LAKE DR",
"city": "WATERLOO",
"state": "IL",
"postal_code": "622983031",
"telephone_number": "618-246-7894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 S LINCOLN ST",
"city": "SMITHTON",
"state": "IL",
"postal_code": "622851617",
"telephone_number": "618-235-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERN",
"first_name": "AMANDA",
"name_prefix": "Mrs.",
"credential": "MS CCC SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-15",
"last_updated": "2017-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146.011039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smithton, IL
- Steven J Crowe, PT
- Delaney Therapy Innovations
- Family Focus Chiropractic PLLC (Family Focus Chiropractic)
- Groceries of Southern Illinois LLC (Smithton Pharmacy)
- Katie Neff Chiro
- Molly Katherine Klein, DC
- Kunevich Chiropractic and Acupuncture, PLLC
- Catherine Edith Kunevich, DC
- Laboratory Corporation of America Holdings
- Kristen Nicole Massey, APN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.