Active NPI
Amanda Jade Clayton Vega, M.A.
- Speech-Language Pathologist
- Odessa, TX
National Provider Identifier
1982017190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 109565
- Practice address
- 620 N Alleghaney Ave
Odessa, TX 79761-4408 - Phone
- (432) 332-8244
- NPI assigned
- Jun 5, 2014
- 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 | 109565 | TX | Primary |
Addresses
Primary practice location
620 N Alleghaney Ave
Odessa, TX 79761-4408
Mailing address
1060 Old San Antonio Rd
Buda, TX 78610-7900
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109565 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permian Basin Rehabilitation Center | Past | Accepting new patients | |
| Permian Basin Rehabilitation Center for Crippled Children and Adults | Speech-Language Pathologist | Past | Accepting new patients |
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.
-
- Audiologist
- Odessa, TX
- NPI 1992918585
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Odessa, TX
- NPI 1104958701
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665964800000",
"number": "1982017190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1060 OLD SAN ANTONIO RD",
"city": "BUDA",
"state": "TX",
"postal_code": "786107900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 N ALLEGHANEY AVE",
"city": "ODESSA",
"state": "TX",
"postal_code": "797614408",
"telephone_number": "432-332-8244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VEGA",
"first_name": "AMANDA",
"middle_name": "JADE CLAYTON",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-05",
"last_updated": "2022-10-17",
"certification_date": "2022-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "109565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Odessa, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.