Individual provider Active NPI

Amanda Marie Akimov

  • Speech-Language Pathologist
  • Los Angeles, CA
National Provider Identifier
1972219319
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
33516 Issued in CA
Practice address
633 W 5TH St Ofc 2876B
Los Angeles, CA 90071-2005
Phone
(512) 399-0064
NPI assigned
Jan 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X
Speech-Language Pathologist 235Z00000X SA20416 FL
Speech-Language Pathologist 235Z00000X 33516 CA Primary

Addresses

Primary practice location

633 W 5TH St Ofc 2876B
Los Angeles, CA 90071-2005

Mailing address

633 W 5TH St Ofc 2876B
Los Angeles, CA 90071-2005
Phone (512) 399-0064

Other practice location 1

111 N Orange Ave Ste 800
Orlando, FL 32801-2381
Phone (512) 399-0064

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

Practice roles

OrganizationSpecialtyStatusNew patients
Expressable Speech-Language Pathology, P.C. Speech-Language Pathologist CurrentSince Feb 6, 2023 Accepting new patients
Little Waves Speech Therapy LLC Current Accepting new patients

Locations

633 W 5th St
Ste 2876B
Los Angeles, CA 90071

633 W 5th St
Ofc 2876B
Los Angeles, CA 90071

111 N Orange Ave
Ste 800
Orlando, FL 32801
Phone (212) 287-4257

7600 Chevy Chase Dr
Ste 300
Austin, TX 78752
Phone (512) 318-2503

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1972219319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 W 5TH ST OFC 2876B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900712005",
            "telephone_number": "512-399-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 W 5TH ST OFC 2876B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900712005",
            "telephone_number": "512-399-0064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 N Orange Ave Ste 800",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328012381",
            "country_code": "US",
            "telephone_number": "512-399-0064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AKIMOV",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA20416",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "33516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.